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目的:通过检测趋化因子受体(CXCR4)在肾上腺良性嗜铬细胞瘤(BPCC)和恶性嗜铬细胞瘤(MPCC)中的表达,探讨诊断MPCC的辅助指标,为鉴别嗜铬细胞瘤(PCC)的生物学行为提供依据。方法:选取1996至2009年期间我院临床资料和病理资料完整的PCC手术标本141例(其中BPCC113例为良性组,MPCC28例为恶性组),另取10例因良性肾疾患行肾切除时获取的同侧正常肾上腺髓质作为对照组。采用免疫组化技术检测BPCC、MPCC及对照组中CXCR4的表达;同时随机选取60例标本,其中BPCC40例,MPCC20例,对患者的临床资料进行统计分析。结果:CXCR4在MPCC组中的表达率为85.71%,明显高于其在BPCC组中的表达(38.05%),两组间差异有统计学意义(P<0.05)。临床资料示MPCC组发病年龄明显低于BPCC组,MPCC平均发病年龄为38岁,BPCC平均发病年龄为45岁(P<0.05)。结论:CXCR4可作为MPCC的预判指标。对年龄较轻的PCC患者,应警惕其为恶性的可能。
Objective: To investigate the expression of chemokine receptor CXCR4 in benign adrenal pheochromocytoma (BPCC) and malignant pheochromocytoma (MPCC) ) To provide the basis for the biological behavior. Methods: A total of 141 surgical specimens of PCC from 1996 to 2009 with complete clinical and pathological data (including benign group of BPCC113 and malignant group of MPCC28) were obtained from 10 cases of nephrectomy. Ipsilateral normal adrenal medulla as a control group. Immunohistochemical technique was used to detect the expression of CXCR4 in BPCC, MPCC and control groups. Meanwhile, 60 samples were selected randomly, including 40 cases of BPCC and 20 cases of MPCC. The clinical data of the patients were statistically analyzed. Results: The expression of CXCR4 in MPCC group was 85.71%, which was significantly higher than that in BPCC group (38.05%). The difference between the two groups was statistically significant (P <0.05). The clinical data showed that the onset age of MPCC group was significantly lower than that of BPCC group. The mean age of onset of MPCC was 38 years and that of BPCC was 45 years (P <0.05). Conclusion: CXCR4 can be used as a predictor of MPCC. For younger patients with PCC, should be wary of the possibility of its malignant.