Department of Pathology, University of Colorado Medical Center, Aurora, CO, USA.
Am J Clin Pathol. 2013 Sep;140(3):410-8. doi: 10.1309/AJCP8DMPEIMVH6YP.
To compare the immunohistochemical expression of diagnostic markers in primary clear cell renal cell carcinomas (RCCs) and their matched metastases.
Tissue microarrays were constructed from 15 pairs of primary and metastatic clear cell RCCs and then evaluated for the immunohistochemical expression of renal cell carcinoma antigen (RCCA), kidney-specific cadherin, carbonic anhydrase IX (CAIX), and paired box genes 2 (PAX2) and 8 (PAX8).
There was significantly higher overall marker expression in metastatic tumors compared to their matched primaries (P < .001). Individually, there was greater CAIX, PAX2, and PAX8 expression and lower RCCA expression in metastatic tumors. Most importantly, a significant proportion of originally RCCA-positive tumors lost such expression in metastases.
Metastatic RCCs have significantly higher expression of PAX2 and PAX8 compared to primary RCCs. RCCA is not very reliable in this diagnostic setting, both because of its lower overall sensitivity and loss of expression in metastatic RCCs.
比较原发性透明细胞肾细胞癌（RCC）及其配对转移灶中诊断标志物的免疫组织化学表达。
从 15 对原发性和转移性透明细胞 RCC 构建组织微阵列，然后评估肾细胞癌抗原（RCCA）、肾脏特异性钙黏蛋白、碳酸酐酶 IX（CAIX）以及配对盒基因 2（PAX2）和 8（PAX8）的免疫组织化学表达。
与配对的原发性肿瘤相比，转移性肿瘤的整体标志物表达明显更高（P <.001）。单独来看，转移性肿瘤中 CAIX、PAX2 和 PAX8 的表达更高，而 RCCA 的表达更低。最重要的是，原本 RCCA 阳性的肿瘤中有相当一部分在转移灶中失去了这种表达。
与原发性 RCC 相比，转移性 RCC 中 PAX2 和 PAX8 的表达明显更高。在这种诊断环境中，RCCA 不是很可靠，这既是因为其总体敏感性较低，也是因为转移性 RCC 中表达丢失。
