de Campos Eurico Cleto Ribeiro, da Fonseca Francisco Paulo, Zequ Stênio de Cássio, Guimarães Gustavo Cardoso, Soares Fernando Augusto, Lopes Ademar
Rev Col Bras Cir. 2013 Nov-Dec;40(6):471-5. doi: 10.1590/s0100-69912013000600009.
To evaluate the frequency of deletion of the PTEN gene in renal cell carcinoma (RCC) and its impact on the rates of overall and disease-free survival.
We analyzed 110 patients with renal cell carcinoma who underwent radical or partial nephrectomy between 1980 and 2007. In 53 cases it was possible to analyse the PTEN gene by the method of fluorescent in situ hybridization using the technique of tissue microarray. For statistical analysis, patients were classified in two groups according to the presence or absence of the deletion.
The mean follow-up time was 41.9 months. Hemizygous deletion was detected in 18 patients (33.9%), while the homozygous one was present in three (5.6%). Deletion was present in approximately 40% of the analyzed cases. Monosomy and trisomy were detected in nine (17%) and two patients (3.8%), respectively. In 21 patients (39.6%) the analysis of the PTEN gene by in situ hybridization was normal. There were no statistically significant differences in overall (p = 0.468) and disease-free (p = 0.344) survival rates between patients with or without deletion. Factors which were independent for overall survival: TNM clinical stage, symptoms at diagnosis, high Fuhrmann grade, performance status (ECoG) and tumor recurrence. Disease-free survival was influenced only by the clinical TNM stage.
Deletion of the PTEN gene in RCC was detected with a frequency of approximately 40% and its presence was not determinant of lower survival rates, the traditional prognostic factors remaining as determinants of outcome.
评估肾细胞癌(RCC)中PTEN基因缺失的频率及其对总生存率和无病生存率的影响。
我们分析了1980年至2007年间接受根治性或部分肾切除术的110例肾细胞癌患者。其中53例通过组织芯片技术采用荧光原位杂交方法分析PTEN基因。为进行统计分析,根据是否存在缺失将患者分为两组。
平均随访时间为41.9个月。18例患者(33.9%)检测到半合子缺失,3例(5.6%)存在纯合子缺失。约40%的分析病例存在缺失。分别在9例(17%)和2例患者(3.8%)中检测到单体性和三体性。21例患者(39.6%)的原位杂交PTEN基因分析正常。有或无缺失患者的总生存率(p = 0.468)和无病生存率(p = 0.344)无统计学显著差异。总生存的独立因素:TNM临床分期、诊断时症状、高Fuhrmann分级、体能状态(ECoG)和肿瘤复发。无病生存仅受临床TNM分期影响。
肾细胞癌中PTEN基因缺失的检测频率约为40%,其存在并非较低生存率的决定因素,传统预后因素仍是结局的决定因素。