CAJ | 학술논문

目的：探讨存活素和人类白细胞抗原I类分子（ HLA-Ⅰ）在肾透明细胞癌（ CCRCC）组织中的表达及其与CCRCC患者预后的关系。方法应用免疫组化方法检测2006年2月至2010年2月90例CCRCC组织及其中10例癌旁正常肾组织中存活素和HLA-Ⅰ的表达情况，应用单因素及多因素分析存活素和HLA-Ⅰ与CCRCC患者年龄、性别、分级、分期、淋巴结情况等临床特征以及与预后的关系。结果 CCRCC 组织中存活素的表达阳性率为82．2％（74/90），HLA-Ⅰ表达下调率为67．8％（61/90），存活素阳性率与肿瘤分级（P＝0．016）、分期（P＝0．000）及淋巴结转移（P＝0．001）相关，而HLA-Ⅰ的表达下调率与患者年龄、性别以及肿瘤分级、分期和淋巴结转移均无关（ P＞00．5）。存活素表达阴性者的无瘤生存率（25．0％，4/16）高于表达阳性者（52．7％，39/74），差异有统计学意义（P＝0．037）；HLA-Ⅰ表达正常者的无瘤生存率（27．6％，8/29）高于表达下调者（60．7％，37/61），差异有统计学意义（ P＝0．020）。单因素及多因素分析结果表明存活素（P ＝0．033）、HLA-Ⅰ（ P＝0．026）及两者结合（P＝0．014）可作为预测CCRCC患者预后的重要指标。结论存活素阳性表达及HLA-Ⅰ表达下调对预测CCRCC患者无瘤生存期及总生存期有重要意义。
목적：탐토존활소화인류백세포항원I류분자（ HLA-Ⅰ）재신투명세포암（ CCRCC）조직중적표체급기여CCRCC환자예후적관계。방법응용면역조화방법검측2006년2월지2010년2월90례CCRCC조직급기중10례암방정상신조직중존활소화HLA-Ⅰ적표체정황，응용단인소급다인소분석존활소화HLA-Ⅰ여CCRCC환자년령、성별、분급、분기、림파결정황등림상특정이급여예후적관계。결과 CCRCC 조직중존활소적표체양성솔위82．2％（74/90），HLA-Ⅰ표체하조솔위67．8％（61/90），존활소양성솔여종류분급（P＝0．016）、분기（P＝0．000）급림파결전이（P＝0．001）상관，이HLA-Ⅰ적표체하조솔여환자년령、성별이급종류분급、분기화림파결전이균무관（ P＞00．5）。존활소표체음성자적무류생존솔（25．0％，4/16）고우표체양성자（52．7％，39/74），차이유통계학의의（P＝0．037）；HLA-Ⅰ표체정상자적무류생존솔（27．6％，8/29）고우표체하조자（60．7％，37/61），차이유통계학의의（ P＝0．020）。단인소급다인소분석결과표명존활소（P ＝0．033）、HLA-Ⅰ（ P＝0．026）급량자결합（P＝0．014）가작위예측CCRCC환자예후적중요지표。결론존활소양성표체급HLA-Ⅰ표체하조대예측CCRCC환자무류생존기급총생존기유중요의의。
Objective To investigate the expression of survivin/Human leukocyte antigen class I ( HLA-Ⅰ) proteins and its physiological significance in clear cell renal cell carcinoma ( CCRCC ) . Methods Immunohistochemistry was used to analyze survivin/HLA-Ⅰ protein expression in 90 cases of CCRCC and 10 normal tissues to study relationships with clinical symptoms and disease prognosis . Resutl s The level of survivin protein expression was found to be significantly higher in CCRCC tissues 82.2%( 74/90) than in normal tissues( 0/10).However, the relative amount of HLA-Ⅰprotein in colorectal cancer tis-sue was also found to be significantly lower 67.8%(61/90) than in normal tissues 90%(9/10).Survivin expression was associated with tumor grade , stage,and lymph node metastasis ( P=0.000, P=0.016, and P=0.001, respectively ) .Conversely , lost HLA-Ⅰexpression did not have any associations with clinicopath-ological data (P>0.05).Survivin negative patients (25.0%, 4/16) had a higher tumor-free survival rate than patients (52.7%, 39/74)with survivin expression (P=0.037).Patients (27.6%, 8/29) with normal HLA-Ⅰlevels had a higher tumor-free survival rate than those ( 60.7%, 37/61) with reduced HLA-Ⅰlev-els (P=0.020).The univariate and multivariate analyses indicated that expression of survivin and HLA indi -vidually and in combination were independent predictors for CCRCC patient survival . Conclusions Over-expression of survivin but reduced HLA-Ⅰ expression is associated with CCRCC development and progres-sion.