【摘要】 目的细胞间黏附分子-1(intercellular cell adhesion molecule-1,ICAM1)在多种恶性肿瘤中都发挥着重要作用,但其对肾透明细胞癌(clear-cell renal cell carcinoma,ccRCC)的影响鲜见报道。本研究旨在探讨ICAM1在ccRCC预后判断以及早期诊断中的意义。方法随机选择2000-01-18-2010-09-08皖南医学院弋矶山医院ccRCC手术冷冻标本173例,利用免疫组织化学(immunohistochemistry,IHC)方法检测ICAM1在ccRCC中的表达,并分析ICAM1表达与临床病理参数的相关性。应用生存分析研究ICAM1表达对ccRCC患者肿瘤特异生存率(cancer-specific survival,CSS)的影响。通过计算受试者工作特征曲线(receiver operating charccteristic curve,ROC)下的面积(area under the ROC curve,AUC)来评价ICAM1表达对ccRCC早期诊断的价值。结果173例ccRCC标本组织中,ICAM1阳性率为83.2%(144/173);173例对应的癌旁正常肾小管上皮组织中,ICAM1均为阴性。ICAM1在男性(χ~2=9.208,P=0.002)、T3/T4期(χ~2=5.207,P=0.022)、非N0M0期(χ~2=4.306,P=0.038)以及肾盂侵犯(χ~2=4.124,P=0.042)等亚组中高表达率分别为56.9%(74/130)、65.9%(27/41)、75.0%(12/16)和67.9%(19/28),均高于对照组,差异有统计学意义。Kaplan-Meier生存分析提示,ICAM1高表达时,ccRCC患者的CSS显著下降(P<0.001),5和10年累积CSS与ICAM1低表达患者相比,分别下降了21.6%和14.1%。Cox回归分析提示,ICAM1是判断ccRCC患者CSS的独立预测因子,P=0.005。ICAM1在ccRCC早期诊断中的AUC值为0.916,P<0.001。结论 ICAM1高表达时,ccRCC患者预后差,ICAM1是判断ccRCC患者预后的独立预测因子,并且可能成为ccRCC早期诊断的潜在标志物。更多还原

【Abstract】 OBJECTIVE The intercellular adhesion molecule-1(ICAM1)has been reported to function in multiple malignancies,but its effect on clear cell renal cell carcinoma(ccRCC)has rarely been reported.This study aimed to identify the significance of ICAM1 in prognostic prediction and early diagnosis of ccRCC.METHODS ICAM1 expression was inspected by immunohistochemistry(IHC)and correlated with clinicopathologic variables.The impact of ICAM1 expression on cancer-specific survival(CSS)of ccRCC patients was discussed through survival analysis and the value of area under the receiver operating characteristics(ROC)curve(AUC)was calculated to measure the protein’s diagnostic accuracy.RESULTS ICAM1 was positively immunostained in 83.2%(144/173)of 173 ccRCC tissues,but negatively immunostained in all the para-cancerous normal epitheliums of renal tubules.High ICAM1 expression percentages of male sex subgroup(χ~2=9.208,P=0.002),T3/T4 stage subgroup(χ~2=5.207,P=0.022),non-N0M0 stage subgroup(χ~2=4.306,P=0.038)and positive renal pelvis invasion subgroup(χ~2=4.124,P=0.042)were 56.9%(74/130),65.9%(27/41),75.0%(12/16)and 67.9(19/28)respectively and apparently larger than control groups.Kaplan-Meier survival analysis illustrated that high ICAM1 expression was significantly correlated to a decreased CSS(P<0.001),cumulative 5-year and 10-year CSS of ccRCC patients with high ICAM1 expression was decreased by 21.6% and 14.1% compared to low ICAM1 expression group.Multivariate Cox analysis indicated that ICAM1 was an independent predictor for CSS of patients(P=0.005).Furthermore,the AUC value of ICAM1 in diagnosing ccRCC was 0.916(P < 0.001). CONCLUSIONS In conclusion,high ICAM1 expression on tumor cells indicates a poor outcome of patients and ICAM1 is likely to be an independent predictor for the prognosis of ccRCC.Moreover,ICAM1 has a high AUC value and may be a potential and useful diagnostic marker.更多还原