肾细胞癌中Vim、CK7、AMACR和CD10的表达及意义

目的研究波形蛋白(Vim)、细胞角蛋白7(CK7)、α甲酰辅酶A消旋酶(AMACR)和CD10在肾细胞癌(RCC)诊断中的意义。方法应用免疫组化染色检测38例透明细胞RCC、35例乳头状RCC和15例嫌色细胞RCC中Vim、CK7、AMACR和CD10的表达情况。结果Vim阳性表达率在透明细胞(87%)、乳头状(91%)与嫌色细胞RCC(0)间差异极显著(P<0.01)。CK7阳性表达率在透明细胞(11%)、乳头状(74%)和嫌色细胞RCC(93%)间差异极显著(P<0.01);乳头状RCC阳性定位以胞质为主,而嫌色细胞RCC定位以胞膜为主,具有鉴别意义。AMACR阳性表达率在乳头状(89%)、透明细胞(37%)和嫌色细胞RCC(7%)间差异极显著(P<0.01)。CD10阳性表达率在透明细胞(79%)和乳头状(80%)与嫌色细胞RCC(27%)间差异极显著(P<0.01)。结论Vim、CK7、AMACR和CD10在透明细胞、乳头状和嫌色细胞RCC的鉴别诊断中有意义,透明细胞、乳头状和嫌色细胞RCC的免疫组化表型特征分别为Vim( ),CK7(-),AMACR(-)/( ),CD10( )/(-);Vim( ),CK7( )/(-),AMACR( ),CD10( )/(-);Vim(-),CK7( ),AMACR(-),CD10(-)/( )。

Application of immunohistochemistry in diagnosis of renal cell carcinoma

Objective To investigate the expression of vimentin,CK7,alpha-methylacyl-CoA racemase(AMACR) and CD10 in renal cell carcinoma(RCC). Methods Immunohistochemistry of vimentin,CK7,AMACR and CD10 was performed on samples of 38 cases of clear cell RCC,35 cases of papillary RCC and 15 cases of chromophobe RCC. Results Expression of vimentin was significantly different between clear cell RCC(87%),papillary RCC(91%) and chromophobe RCC(0%)((P<0.01).) CK7 expression was significantly different between clear cell RCC(11%) and papillary RCC(74%),chromophobe RCC(93%)(P<0.01).CK7 was cytoplasm-positive in papillary RCC while characteristic membrane staining was observed in chromophobe RCC.Expression of AMACR was significantly different between papillary RCC(89%) and clear cell RCC(37%),chromophobe RCC(7%)(P<0.01).CD10 expression was significantly different between clear cell RCC(79%),papillary RCC(80%) and chromophobe RCC(27%)(P<0.01). Conclusion Immunohistochemical staining for vimentin,CK7,AMACR and CD10 appears to be a useful adjunct in the differential diagnosis of clear cell RCC,papillary RCC and chromophobe RCC.The characteristic phenotypes of clear cell RCC,papillary RCC and chromophbe RCC are vimentin CK7-AMACR-/ CD10 /-,vimentin CK7 /-AMACR CD10 /-and vimentin-CK7 AMACR-CD10-/ ,respectively.