摘要
目的探讨Kisspeptin-10在保留肾单位手术的小肾肿物(SRM)中鉴别良恶性肿瘤的作用。方法选取我院行单侧保留肾单位手术的155例SRM(≤4 cm)患者进行分析,采集其术前血样,并收集其临床、影像学和病理学资料。依据术后病理分为透明细胞肾细胞癌组(RCC)(50例),乳头状RCC组(50例),嫌色细胞RCC组(24例)和肾血管平滑肌脂肪瘤(RAML)组(31例)。同时选取30例肾结石和前列腺增生患者作为年龄匹配对照组。比较不同组间Kisspeptin-10浓度及临床数据间的差异,分析透明细胞RCC和乳头状RCC病理分级与Kisspeptin-10的相关性,并计算Kisspeptin-10数值来预测RCC的发生。结果与对照组比较,SRM的Kisspeptin-10浓度水平显著增加[(9.47±4.55) pmol/L比(6.88±1.78) pmol/L,P<0.05],而不同病理RCC间Kisspeptin-10浓度水平比较差异有统计学意义(P<0.05);而RENAL评分、PADUA评分和肿瘤直径在不同分组间比较差异无统计学意义(P>0.05)。在透明细胞RCC和乳头状RCC患者中,其WHO/ISUP分级与Kisspeptin-10呈负相关(r=-0.325,P<0.05)。受试者工作特征曲线分析显示Kisspeptin-10浓度8.35 pmol/L是预测RCC的最佳值,平均曲线下面积0.852,灵敏度为87.1%,特异性为67.7%。结论Kisspeptin-10浓度水平有助于鉴定SRM的良恶性。
Objective To identify pathological types in small renal masses (SRM) treated with unilateral nephron-sparing surgery using Kisspetin-10.Methods Analysis of clinical, imaging and pathological data in 155 SRM (≤4 cm) treated with unilateral nephron-sparing surgery. Preoperative blood samples and clinicopathological data were collected. The cohort of patients were divided into four groups: 50 patients with clear cell renal cell carcinoma (ccRCC), 50 with papillary renal cell carcinoma (pRCC), 24 with chromophobe renal cell carcinoma (chRCC) and 31 with renal angiomyolipoma (RAML). 30 age-matched controls included urolithiasis and benign prostatic hyperplasia patients. The differences among four groups and correlation of pathological grade and Kisspeptin-10 were analyzed, then the best cut-off value of Kisspeptin-10 was calculated between renal cell carcinoma and controls.Results Kisspeptin-10 in SRM groups is significantly higher than controls [(9.47±4.55) pmol/L vs. (6.88±1.78) pmol/L, P<0.05], Among the subgroups, Kisspeptin-10 was detected at significantly different levels (P<0.05). but RENAL scores, PADUA scores and diameter of tumor were found no statistical significance (P>0.05). World Health Organization/ International Society of Urological Pathology (WHO/ISUP) grading system in ccRCC and pRCC groups are associated with Kisspeptin-10 (r=-0.325, P<0.05). Receiver operating characteristic curve analyses revealed the best cut-off values are 8.35 pmol/L (87.1% sensitivity, 67.7% specificity, respectively) and the area under the curve is 0.852.Conclusion Kisspeptin-10 may be used to identify the SRM subtype differentiation.
作者
张国贤
任川川
王焱
朱文
王庆伟
文建国
Zhang Guoxian;Ren Chuanchuan;Wang Yan;Zhu Wen;Wang Qingwei;Wen Jianguo(Department of Urology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2019年第1期147-149,共3页
Chinese Journal of Experimental Surgery
基金
国家自然科学基金(81670689)
河南省科技重点项目(182102410002).
