Erdem Selcuk, Yegen Gulcin, Telci Dilek, Yildiz Ibrahim, Tefik Tzevat, Issever Halim, Kilicaslan Isin, Sanli Oner
Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
World J Urol. 2015 Oct;33(10):1553-60. doi: 10.1007/s00345-014-1462-7. Epub 2014 Dec 17.
The aim of this study was to investigate the role of transglutaminase 2(TG2) in renal cell carcinoma (RCC) by comparing the immunohistochemistry staining of primary and metastatic tumor tissues.
A total of 33 metastatic RCC(mRCC) and 33 non-metastatic RCC (nmRCC) patients who were matched as closely as possible based on gender, age, nuclear grade and pathologic T stage were retrospectively investigated. TG2 immunohistochemistry staining was performed on paraffin-embedded primary tumor tissues from both patient groups and on metastatic tissues from mRCC patients. The tissues were scored from 0 to 7 according to the TG2 staining. Furthermore, the patients were stratified into two groups using median primary tumor staining score as the cutoff value: Group 1 (high risk, n = 41) and Group 2(low risk, n = 22). The clinical, histopathological and survival outcomes were compared between these risk groups using Chi-square test, t test, Mann-Whitney U test and Kaplan-Meier survival analyses.
The median TG2 score for primary tumor was 5 for the entire study population. The median primary tumor TG2 score of the mRCC patients was significantly higher compared to the nmRCC patients (6 vs. 4, p < 0.001). The TG2 score between the primary and metastatic tissues of mRCC patients was not significantly different (6 vs. 7, p = 0.086). The percentage of metastatic patients was significantly higher in Group 1 compared to Group 2 (68.3 vs. 18.2 %, p < 0.001). Kaplan-Meier analyses showed that 5-year disease-free (34.9 vs. 92.9 %, p = 0.001) and cancer-specific (47.4 vs. 86.5 %, p = 0.04) survival rates were significantly lower in high-risk group.
The increased expression of TG2 in primary tumor predicts metastasis in RCC patients and is also associated with a decrease in disease-free and cancer-specific survival outcomes.
本研究旨在通过比较原发性和转移性肿瘤组织的免疫组化染色，探讨转谷氨酰胺酶2（TG2）在肾细胞癌（RCC）中的作用。
回顾性研究了33例转移性肾细胞癌（mRCC）患者和33例非转移性肾细胞癌（nmRCC）患者，这些患者在性别、年龄、核分级和病理T分期方面尽可能匹配。对两组患者石蜡包埋的原发性肿瘤组织以及mRCC患者的转移组织进行TG2免疫组化染色。根据TG2染色情况，将组织从0到7进行评分。此外，以原发性肿瘤染色评分中位数作为临界值，将患者分为两组：第1组（高风险，n = 41）和第2组（低风险，n = 22）。使用卡方检验、t检验、曼-惠特尼U检验和Kaplan-Meier生存分析比较这些风险组之间的临床、组织病理学和生存结果。
整个研究人群原发性肿瘤的TG2评分中位数为5。mRCC患者原发性肿瘤的TG2评分中位数显著高于nmRCC患者（6比4，p < 0.001）。mRCC患者原发性组织和转移组织之间的TG2评分无显著差异（6比7，p = 0.086）。第1组转移性患者的百分比显著高于第2组（68.3%比18.2%，p < 0.001）。Kaplan-Meier分析显示，高风险组的5年无病生存率（34.9%比92.9%，p = 0.001）和癌症特异性生存率（47.4%比86.5%，p = 0.04）显著更低。
原发性肿瘤中TG2表达增加预示着RCC患者发生转移，并且还与无病生存率和癌症特异性生存率降低相关。
