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目的观察透明细胞性肾细胞癌(CCRCC)、嫌色性肾细胞癌(CRCC)临床病理特点,探讨细胞角蛋白7(CK7)、波形蛋白(Vimentin)在CCRCC与CRCC鉴别诊断中的价值。方法收集2010至2015年34例CCRCC与15例CRCC患者的临床资料,回顾性分析其手术切除肿瘤样本的病理学形态特点,应用免疫组化法测定肿瘤组织中CK7及Vimentin表达水平,并与20例正常肾组织标本对比,分析其在鉴别诊断中的价值。结果 CCRCC组CK7阳性率(2.94%)显著低于CRCC组(100%),Vimentin阳性率(100%)显著高于CRCC组(0),差异均有统计学意义(P均<0.01)。正常肾组织中Vimentin表达均为弱阳性,CCRCC组则多为阳性与强阳性,二者比较差异有统计学意义(P<0.05);CCRCC分期及分级越高,强阳性所占比例越高(P均<0.05)。正常肾组织中CK7表达均为弱阳性,CRCC则多为阳性、强阳性,二者比较差异有统计学意义(P<0.05);不同分级的CRCC患者CK7阳性表达程度有统计学差异(P<0.05)。CRCC患者Hale胶体铁染色阳性率为80.00%,CCRCC患者无1例阳性,二者比较差异有统计学意义(P<0.01)。结论 CK7、Vimentin在CCRCC、CRCC鉴别诊断中有重要意义,是预测肾细胞癌发生、进展及预后的关键指标。
Objective To investigate the clinicopathological features of clear cell renal cell carcinoma (CCRCC) and chromophobe renal cell carcinoma (CRCC) and to explore the value of CK7 and Vimentin in the differential diagnosis between CCRCC and CRCC. Methods The clinical data of 34 cases of CCRCC and 15 cases of CRCC from 2010 to 2015 were collected. The histopathological features of the resected tumor samples were retrospectively analyzed. The expression of CK7 and Vimentin in tumor tissues were detected by immunohistochemistry and compared with 20 Cases of normal renal tissue samples comparison, analysis of its value in the differential diagnosis. Results The positive rate of CK7 in CCRCC group (2.94%) was significantly lower than that in CRCC group (100%). The positive rate of Vimentin in 100 cases of CRCC group was significantly higher than that of CRCC group (all P <0.01). The expression of Vimentin in normal renal tissue was weakly positive, while in CCRCC group, the positive rate and the strong positive rate were both in the CCRCC group (P <0.05). The higher the CCRCC stage and grade were, the higher the positive rate was P <0.05). The expression of CK7 in normal renal tissues was weakly positive and CRCC was mostly positive and strongly positive, the difference was statistically significant (P <0.05). The positive expression of CK7 in different grades of CRCC was statistically different (P < 0.05). The positive rate of Hale colloid iron staining was 80.00% in CRCC patients and no positive in CCRCC patients, the difference was statistically significant (P <0.01). Conclusions CK7 and Vimentin are important in the differential diagnosis of CCRCC and CRCC and are the key indicators for predicting the occurrence, progression and prognosis of renal cell carcinoma.