Clusterin蛋白在肾癌组织中的表达及临床意义

目的 探讨clusterin蛋白在肾癌组织中的表达及临床意义。方法 制作87例肾癌组织芯片，应用免疫组织化学方法检测肾癌组织中clusterin蛋白表达，应用TUNEL方法检测细胞凋亡情况，分析clusterin蛋白表达与肾癌细胞凋亡及临床病理学参数之间的相关性。结果 68例有效检测的肾癌组织标本中，clusterin蛋白过度表达15例（22％），且其表达与肿瘤浸润有显著相关性（P=0．004），71％（5／7）的T3肿瘤clusterin蛋白呈过度表达，84％（51／61）的T1、T2肿瘤clusterin蛋白为正常表达。57％（4／7）伴有淋巴结转移的肾癌组织标本clusterin蛋白呈过度表达，阳性率高于无淋巴结转移者（18％，11／61，P=0．059）。clusterin蛋白表达与肿瘤凋亡指数（AI）呈负相关（P=0．0138），61％（8／13）clusterin过度表达的肿瘤表现为低水平的AI值，78％（39／50）clusterin正常表达的肿瘤AI值为高或中水平。结论 肾癌组织中clusterin蛋白过度表达可能与其抗凋亡作用有关，与肾癌的恶性临床表型相关，可作为判断肾癌恶性程度的指标之一。

The expression of clusterin protein in renal carcinoma and its clinical significance

Objective To investigate the protein expression of clusterin in renal carcinoma and its clinical significance. Methods A tissue microarray (TMA) containing 87 cases of renal carcinomas was constructed.Immunohistochemistry and TUNEL methods were used to examine the protein expression of clusterin and the status of apoptosis in these cancer series and to analyze their correlations and the association of clusterin expression with patient's clinicopathologic features. Results Among the 87 cases,68 renal tumors were informative by immunohistochemistry assay, and overexpression of clusterin was observed in 15 cases (22%).In these informative cases,there was a significant association of clusterin expression with the tumor's invasiveness (P=0.004),where 71% (5/7) of stage T_3 tumors presented overexpression of clusterin,while 84% (51/61) of stage T_1 and T_2 tumors showed normal expression of this protein.In addition,there was a trend (P=0.059) that the tumors with lymph node metastasis were more likely to have clusterin overexpression (57%, 4/7) than that without metastasis (18%,11/16).Furthermore, a significant negative correlation between clusterin expression and tumor's apoptotic index (AI) was observed (P=0.0138).In the carcinomas with overexpression of clusterin,61% (8/13) had a lower AI;while in the tumors with normal expression of this protein,78% (39/50) showed a relatively higher AI. Conclusions The clusterin overexpression may function as an anti-apoptosis factor and thus play an important role in the malignant progression of renal carcinoma.The overexpression of clusterin is associated obviously with cancer's invasive clinical phenotype, and it may be used as one of the molecular markers to determine the malignancy of renal carcinoma.