Ehsani Laleh, Osunkoya Adeboye O
Department of Pathology, Emory University School of Medicine, Room H174, 1364 Clifton Road, NE, Atlanta, GA, 30322, USA.
Tumour Biol. 2014 Sep;35(9):8743-7. doi: 10.1007/s13277-014-2141-4. Epub 2014 May 30.
In this study, we investigated microsatellite instability in urothelial carcinoma of the renal pelvis by lack of immunohistochemical staining for MLH1 and MSH2. The study included 44 cases of urothelial carcinoma of the renal pelvis obtained from radical nephroureterectomy specimens at our institution. We evaluated the loss of nuclear immunohistochemical staining of MLH1 and MSH2. Eight of 44 (18 %) patients had negative MLH1 expression and 25/44 (57 %) patients had negative MSH2 expression. Six of 8 (75 %) patients with negative MLH1 expression were male and 2/8 (25 %) patients were female. Nineteen of 25 (75 %) patients with negative MSH2 expression were male, and 6/25 (24 %) patients were female. Seven of 8 (88 %) cases with negative MLH1 expression were high-grade urothelial carcinoma, and 21/25 (84 %) cases with negative MSH2 expression were high-grade urothelial carcinoma. Twenty-one of 44 (48 %) cases had an inverted growth pattern, of which 3/21 (14 %) cases had negative MLH1 expression and 14/21 (67 %) cases had negative MSH2 expression. Our study showed that microsatellite instability based on negative expression of MLH1 and MSH2 was more common in male patients with high-grade urothelial carcinoma. There is a strong correlation between inverted growth pattern and negative MSH2 expression. Microsatellite instability testing should be performed in patients with upper urinary tract carcinoma and may have prognostic value.
在本研究中，我们通过缺乏MLH1和MSH2免疫组化染色来研究肾盂尿路上皮癌中的微卫星不稳定性。该研究纳入了44例在我们机构接受根治性肾输尿管切除术标本中获取的肾盂尿路上皮癌病例。我们评估了MLH1和MSH2细胞核免疫组化染色的缺失情况。44例患者中有8例（18%）MLH1表达阴性，44例中有25例（57%）MSH2表达阴性。MLH1表达阴性的8例患者中有6例（75%）为男性，2例（25%）为女性。MSH2表达阴性的25例患者中有19例（75%）为男性，6例（24%）为女性。MLH1表达阴性的8例病例中有7例（88%）为高级别尿路上皮癌，MSH2表达阴性的25例病例中有21例（84%）为高级别尿路上皮癌。44例病例中有21例（48%）呈内翻生长模式，其中21例中有3例（14%）MLH1表达阴性，14例（67%）MSH2表达阴性。我们的研究表明，基于MLH1和MSH2阴性表达的微卫星不稳定性在高级别尿路上皮癌男性患者中更为常见。内翻生长模式与MSH2阴性表达之间存在强相关性。上尿路癌患者应进行微卫星不稳定性检测，其可能具有预后价值。
