摘要：乳头状肾细胞癌（papillary renal cell carcinoma，PRCC）有2种组织学亚型。近一半病例由于不完全符合其中某一亚型的所有形态学标准，被归为非特殊类型（not otherwise specified，NOS)PRCC。目前尚无标记物能解决这部分PRCC NOS的分类问题。准确的分类可以更好地指导临床治疗。在既往研究中，我们提出了相关的标记物对PRCC进行分型。本研究选取108例PRCC患者样本，对之前从基因组中筛选出的一组潜在鉴别标记物进行免疫组化分析。这组标记物在2种经典PRCC亚型之间的表达具有显著差异，且能对PRCC NOS病例（45%)再次分类。不仅如此，我们应用这些标记物鉴别出了第3种PRCC亚型PRCC3(占病例的35%)。我们利用miRNA表达和拷贝数变异分析证实这3种亚型存在3种不同的分子特征。单变量分析显示，PRCC1的无病生存期显著长于PRCC2和PRCC3(P=0.047)。多变量分析也显示亚型间有显著差别（P=0.025；风险比，6；95%置信区间，1.25~32.2)。结合形态学、免疫组织化学和分子表型，我们提出一种新的PRCC分型系统。最新提出的PRCC3具有与PRCC1和PRCC2重叠的形态学特征，在现有的分型系统中被归为NOS。PRCC3具有独特的分子信号，其临床表现与PRCC2相似。按照新分型系统对PRCC进行分组，这将对指导临床治疗具有重要意义。
关键词：乳头状肾细胞癌，乳头状肾细胞癌NOS，ABCC2
The American Journal of Surgical Pathology中文版声明：
©2018 Wolters Kluwer Health
The material is published by Wolters Kluwer Health with the permission of American Journal of Surgical Pathology.No part of this publication may be reproduced in any form,stored in a retrieval system or transmitted in any form,by any means,without prior written permission from Wolters Kluwer Health.Opinions expressed by the authors and advertisers are not necessarily those of the American Journal of Surgical Pathology, its affiliates,or of the Publisher.The American Journal of Surgical Pathology,its affiliates,and the Publisher disclaim any liability to any party for the accuracy,completeness,efficacy,or availability of the material contained in this publication (including drug dosages) or for any damages arising out of the use or non-use of any of the material contained in this publication.
Although advertising material is expected to conform to ethical (medical) standards,inclusion in this publication does not constitute a guarantee or endorsement of the quality or value of such product or of the claims made of it by its manufacturer.
苏公网安备 32011402011742