微小染色体维持蛋白2（MCM2）是肾母细胞瘤中一种新的预后增殖标志物。

Minichromosome maintenance 2 (MCM2) is a new prognostic proliferative marker in Wilms tumour.

作者信息

Taran Katarzyna, Sitkiewicz Anna, Andrzejewska Ewa, Kobos Józef

机构信息

Department of Pathology, Medical University of Lodz, Łódz, Poland

出版信息

Pol J Pathol. 2011;62(2):84-8.

PMID:21866463

Abstract

OBJECTIVE

We examined expression of minichromosome maintenance 2 (MCM2) by immunohistochemistry in nephrectomy specimens of children with nephroblastoma treated according to the Society International d'Oncologie Pediatrique (SIOP) scheme to determine its potential prognostic significance.

MATERIAL AND METHODS

18 children with nephroblastoma, 9 females and 9 males, 2 months to 7 years of age, treated in the Department of Oncology and Paediatric Surgery, Medical University of Lodz, during the period 1994-2006 were analysed. Children were treated by neoadjuvant chemotherapy and subsequent nephrectomy according to SIOP protocols -93 and 2001 and followed up from 2 to 11 years. The tumour stage and classification in nephrectomy specimens were established according to the revised 2001 SIOP working classification of renal tumours of childhood.

RESULTS

In low risk nephroblastoma MCM2 expression was low, ranging from 0% in two cases of completely necrotic nephroblastoma to 5% in one child with cystic partially differentiated nephroblastoma. In mesoblastic nephroma, which is a distinct type of neoplasm with a low malignant potential and the most common congenital renal neoplasm, MCM2 expression was variable ranging from 2-5% in 2 children with stage I disease to 70% in one child with stage III disease In intermediate risk nephroblastoma MCM2 expression was low (10%) in one case of regressive type nephroblastoma and stage II disease and intermediate to high in children with epithelial type nephroblastoma, ranging from 40-50% in one case with stage I disease to 70% and 70-100% in 2 children with stage I and stage IV disease, respectively. In high risk nephroblastoma (7 children with nephroblastoma blastemal type) MCM2 expression was intermediate to high, ranging from 40 to 90%. MCM2 expression tends to be lower in children with less advanced stage of disease (stage II) and higher in more advanced disease (stage III and IV). Two children with blastemal type and high (> 60% MCM2) died of disease within 2-4 years from diagnosis and one child was lost to follow-up. Both children who died were older 8.5 yo M and 7 yo M and presented with advanced disease stage IV or III with anaplasia.

CONCLUSION

MCM2 is a promising prognostic factor in WT treated according to the SIOP scheme.

摘要

目的

我们通过免疫组织化学方法检测了按照国际小儿肿瘤学会（SIOP）方案治疗的肾母细胞瘤患儿肾切除标本中微小染色体维持蛋白2（MCM2）的表达，以确定其潜在的预后意义。

材料与方法

分析了1994年至2006年期间在罗兹医科大学肿瘤学与小儿外科接受治疗的18例肾母细胞瘤患儿，其中9例女性，9例男性，年龄2个月至7岁。患儿按照SIOP -93和2001方案接受新辅助化疗及后续肾切除术，并进行了2至11年的随访。根据2001年修订的SIOP儿童肾肿瘤工作分类法确定肾切除标本中的肿瘤分期和分类。

结果

在低危肾母细胞瘤中，MCM2表达较低，从2例完全坏死性肾母细胞瘤中的0%到1例囊性部分分化型肾母细胞瘤患儿中的5%不等。在中胚层肾瘤中，这是一种恶性潜能较低且最常见的先天性肾肿瘤的独特肿瘤类型，MCM2表达各不相同，从2例I期疾病患儿中的2% - 5%到1例III期疾病患儿中的70%不等。在中危肾母细胞瘤中，1例退行型肾母细胞瘤和II期疾病患儿的MCM2表达较低（10%），而上皮型肾母细胞瘤患儿的MCM2表达为中度至高度，从1例I期疾病患儿中的40% - 50%到2例I期和IV期疾病患儿中的70%及70% - 100%不等。在高危肾母细胞瘤（7例胚芽型肾母细胞瘤患儿）中，MCM2表达为中度至高度，范围为40%至90%。疾病分期较晚（II期）的患儿MCM2表达往往较低，而疾病分期较晚（III期和IV期）的患儿MCM2表达较高。2例胚芽型且MCM2高表达（> 60%）的患儿在诊断后2至4年内死于疾病，1例患儿失访。死亡的2例患儿均为8.5岁男性和7岁男性，均表现为晚期IV期或III期伴间变。