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目的:探讨肾透明细胞癌中Ki-67指数、EGFR表达及DNA倍体的临床意义。方法:经病理确诊的肾透明细胞癌66例患者的手术标本,用免疫组化染色法检测Ki-67指数及EGFR表达,流式细胞术检测DNA倍体,并分析其与临床病理特征之间的关系。结果:肾透明细胞癌Ki-67阳性细胞占59.4%(38/64),Ki-67指数与肿瘤分级(P<0.05)、DNA倍体异常(P<0.05)显著相关,与EGFR表达无相关性。EGFR蛋白表达阳性率为86.2%(56/65),其胞浆表达与肿瘤分级呈正相关(P<0.05);其胞膜和膜浆混合表达没有发现相关性。检测45例DNA倍体,31例(68.9%)为异倍体。结论:透明细胞癌中Ki-67指数和EGFR与肿瘤分级密切相关,提示Ki-67和EGFR有可能成为临床判断预后的重要分子指标。DNA异倍体与Ki-67指数显著相关,提示DNA也可能提示肾透明细胞癌临床预后。联合检测上述3种指标,并与临床指标结合,将能更准确地判断预后并指导临床治疗。EGFR在肾透明细胞癌中的高表达,使其可能成为个体化治疗的靶向分子。
Objective: To investigate the clinical significance of Ki-67 index, EGFR expression and DNA ploidy in renal clear cell carcinoma. Methods: Sixty-six patients with pathologically confirmed renal clear cell carcinoma were examined with immunohistochemical staining for Ki-67 index and EGFR expression. DNA ploidy was detected by flow cytometry and the relationship between Ki-67 and clinicopathological features was analyzed Relationship. Results: Ki-67 positive cells in renal clear cell carcinoma accounted for 59.4% (38/64), Ki-67 index was significantly correlated with tumor grade (P <0.05) and DNA ploidy abnormality (P <0.05), but not with EGFR Sex. The positive rate of EGFR protein was 86.2% (56/65). The expression of EGFR protein was positively correlated with the tumor grade (P <0.05). No correlation was found between the expression of EGFR protein and the plasma membrane. 45 cases detected DNA ploidy, 31 cases (68.9%) aneuploidy. Conclusion: The Ki-67 index and EGFR in clear cell carcinoma are closely related to tumor grade, suggesting that Ki-67 and EGFR may be important molecular markers for clinical judgment of prognosis. DNA aneuploidy and Ki-67 index were significantly correlated, suggesting that DNA may also prompt the clinical prognosis of renal clear cell carcinoma. Joint detection of these three indicators, combined with clinical indicators, will be able to more accurately determine the prognosis and guide clinical treatment. The high expression of EGFR in renal clear cell carcinoma makes it likely to be a targeted molecule for individualized therapy.