Islam A H M Manjurul, Ehara Takashi, Kato Haruaki, Hayama Masayoshi, Kobayashi Shinya, Igawa Yasuhiko, Nishizawa Osamu
Department of Urology, Shinshu University School of Medicine, Matsumoto City, Japan.
J Urol. 2004 Mar;171(3):1319-23. doi: 10.1097/01.ju.0000101969.34419.57.
We determined whether the architecture of renal tumor vessels is immunohistochemically different from that of normal renal vessels and related to the various pathological factors that affect prognosis of renal cell carcinoma (RCC).
A total of 52 cases of primary RCC were selected. Tissues from radical nephrectomy specimens were stained with antibody to alpha-smooth muscle actin (alpha-SMA) and calponin h1. Immunostaining was evaluated semiqualitatively as 0-no staining to 3+-strong staining. Tumor cell proliferation was observed using proliferating marker Ki-67. Data were statistically compared with pathological factors, such as tumor size, histological pattern, growth pattern, cell type, nuclear grade, pathological stage and presence or absence of venous invasion.
In normal renal tissues smooth muscle cells of the blood vessels showed strong immunoreactions with antibody to calponin h1 and alpha-SMA. Although alpha-SMA antibody showed similar strong immunoreactions in all types of renal tumor vessels, we observed qualitative alterations in the expression of calponin h1 in different types of RCCs. Strong to moderate immunoreactions with calponin h1 were observed in tumors with expansive growth and an alveolar pattern. Small tumors without venous invasion and chromophobe cell carcinomas also showed strong to moderate expression of calponin h1. Weak or absent expression of calponin h1 was observed significantly in infiltrating tumors, sarcomatous type, large, high grade and high stage tumors associated with significantly higher proliferating indexes.
Our results strongly suggest that the renal tumor vessels are immunohistochemically different from normal renal vessels in respect to calponin h1 expression. We speculate that due to the decrease in or absence of calponin h1 tumor vessels do not develop adequate maturity to maintain vascular integrity. In addition, the distribution of calponin h1 significantly correlated with multiple pathological factors of RCC. Therefore, calponin h1 expression in renal tumor vessels could be a new, important pathological factor in RCC.
我们确定肾肿瘤血管的结构在免疫组织化学上是否与正常肾血管不同，以及是否与影响肾细胞癌（RCC）预后的各种病理因素相关。
共选取52例原发性RCC病例。根治性肾切除标本的组织用抗α-平滑肌肌动蛋白（α-SMA）和钙调蛋白h1抗体染色。免疫染色半定量评估为0-无染色至3+-强染色。使用增殖标志物Ki-67观察肿瘤细胞增殖。数据与肿瘤大小、组织学类型、生长方式、细胞类型、核分级、病理分期以及有无静脉侵犯等病理因素进行统计学比较。
在正常肾组织中，血管平滑肌细胞对钙调蛋白h1和α-SMA抗体显示出强烈免疫反应。虽然α-SMA抗体在所有类型的肾肿瘤血管中均显示出类似的强烈免疫反应，但我们观察到不同类型RCC中钙调蛋白h1表达存在定性改变。在具有膨胀性生长和肺泡样模式的肿瘤中观察到与钙调蛋白h1的强至中度免疫反应。无静脉侵犯的小肿瘤和嫌色细胞癌也显示出钙调蛋白h1的强至中度表达。在浸润性肿瘤、肉瘤样型、大的、高级别和高分期肿瘤中，钙调蛋白h1的弱表达或无表达明显，且增殖指数显著更高。
我们的结果强烈表明，肾肿瘤血管在钙调蛋白h1表达方面在免疫组织化学上与正常肾血管不同。我们推测，由于钙调蛋白h1减少或缺失，肿瘤血管无法发育出足够的成熟度来维持血管完整性。此外，钙调蛋白h1的分布与RCC的多种病理因素显著相关。因此，肾肿瘤血管中钙调蛋白h1的表达可能是RCC中一个新的重要病理因素。
