MN/CA9基因表达在鉴别肾恶性实体肿瘤中的应用。

The use of MN/CA9 gene expression in identifying malignant solid renal tumors.

作者信息

Li Guorong, Cuilleron Muriel, Cottier Michèle, Gentil-Perret Anne, Lambert Claude, Genin Christian, Tostain Jacques

机构信息

Department of Urology, North Hospital, CHU of Saint-Etienne, France.

出版信息

Eur Urol. 2006 Feb;49(2):401-5. doi: 10.1016/j.eururo.2005.10.025. Epub 2005 Dec 19.

DOI:10.1016/j.eururo.2005.10.025

PMID:16387417

Abstract

OBJECTIVE

Small solid renal tumors are increasingly encountered. It is important to determine the malignancy of solid renal tumors for the choice of treatment. MN/CA9 is expressed in malignant renal cells but absent in normal cells. MN/CA9 is one of the most powerful gene markers available for RCC. The objective of this pilot study is to utilize MN/CA9 gene expression in FNA biopsy to determine the malignancy of imaging-indeterminate solid renal tumors.

METHODS

A total of 35 patients with an imaging-indeterminate solid renal mass entered into this study. The molecular protocol consisted of a rapid column extraction of RNA and one-step RT-PCR for the detection of MN/CA9 gene expression. The preoperative molecular diagnosis was compared with postoperative pathology.

RESULTS

There were 28 RCCs (19 clear cell carcinomas, 7 papillary carcinomas and 2 chromophobe carcinomas) and 7 benign tumors proved by postoperative pathology. The overall sensitivity and specificity for MN/CA9 were respectively 68% and 100%. MN/CA9 was positive in 16/19 (84%) FNA biopsies of clear cell RCCs. No false positive appeared for MN/CA9 gene expression. Moreover, MN/CA9 gene expression was positive in 8/13 (62%) of false negative or suspect cytology.

CONCLUSION

Detection of MN/CA9 gene expression in FNA biopsy is possible. Its detection can be helpful in identifying the malignancy among renal tumors.

摘要

目的

越来越多地发现小的实性肾肿瘤。确定实性肾肿瘤的恶性程度对于治疗方案的选择很重要。MN/CA9在恶性肾细胞中表达，但在正常细胞中不表达。MN/CA9是可用于肾细胞癌的最强大的基因标志物之一。本初步研究的目的是利用细针穿刺活检（FNA）中的MN/CA9基因表达来确定影像学上难以确定的实性肾肿瘤的恶性程度。

方法

共有35例影像学上难以确定的实性肾肿块患者进入本研究。分子检测方案包括RNA的快速柱提取和用于检测MN/CA9基因表达的一步法逆转录聚合酶链反应（RT-PCR）。将术前分子诊断与术后病理结果进行比较。

结果

术后病理证实有28例肾细胞癌（19例透明细胞癌、7例乳头状癌和2例嫌色细胞癌）和7例良性肿瘤。MN/CA9的总体敏感性和特异性分别为68%和100%。MN/CA9在19例透明细胞肾细胞癌的16例（84%）FNA活检中呈阳性。MN/CA9基因表达未出现假阳性。此外，MN/CA9基因表达在8/13例（62%）假阴性或可疑细胞学检查中呈阳性。