Department of Urology, Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China.
Vazyme Biotech Co., Nanjing, People's Republic of China.
J Urol. 2015 Sep;194(3):647-52. doi: 10.1016/j.juro.2015.04.080. Epub 2015 Apr 25.
Neutrophil gelatinase associated lipocalin, also known as lipocalin-2, is a 25 kDa protein now considered the biochemical gold standard for the early diagnosis of acute kidney injury. Recently lipocalin-2 was suggested to have an important role in several human neoplasias. In this study we assess lipocalin-2 expression in 2 renal tumor types and analyze its association with clinicopathological parameters and prognosis.
The study group included 189 patients who underwent surgery for renal lesions between 2003 and 2013. Of these patients 105 had clear cell renal cell carcinoma and 84 had papillary renal cell carcinoma. The association of lipocalin-2 immunoexpression and clinicopathological characteristics was evaluated. Cox proportional hazard regression was performed to estimate the prognostic significance of potential confounders in predicting overall and disease-free survival.
Lipocalin-2 expression in different histotypes of analyzed tumors was highly and significantly associated with papillary renal cell carcinoma (p <0.001). In papillary renal cell carcinoma high lipocalin-2 expression was associated with high Fuhrman grade (p <0.001), tumor size greater than 7 cm (p = 0.007), increased TNM stage (p <0.001) and lymph node metastasis (p = 0.009). On univariable and multivariable Cox survival analyses of papillary renal cell carcinoma, after a median followup of 49.1 months (range 7 to 136) lipocalin-2 expression was associated with reduced overall survival (HR 4.10, 95% CI 1.19-14.14, p = 0.026) and disease-free survival (HR 2.56, 95% CI 1.01-6.48, p = 0.047).
Lipocalin-2 over expression may be a prognostic factor in decreased overall and disease-free survival in papillary renal cell carcinoma. The association of lipocalin-2 over expression and poor prognosis with papillary renal cell carcinoma may have potential diagnostic and therapeutic utility.
中性粒细胞明胶酶相关脂质运载蛋白，也称为脂联素-2，是一种 25kDa 的蛋白质，现在被认为是急性肾损伤早期诊断的生化金标准。最近，脂联素-2 被认为在几种人类肿瘤中具有重要作用。在这项研究中，我们评估了 2 种肾肿瘤类型中脂联素-2 的表达，并分析了其与临床病理参数和预后的关系。
研究组包括 189 名 2003 年至 2013 年间因肾脏病变接受手术的患者。其中 105 例为透明细胞肾细胞癌，84 例为乳头状肾细胞癌。评估了脂联素-2 免疫表达与临床病理特征的关系。采用 Cox 比例风险回归分析估计潜在混杂因素对总生存和无病生存预测的预后意义。
分析肿瘤不同组织类型的脂联素-2 表达与乳头状肾细胞癌高度显著相关（p<0.001）。在乳头状肾细胞癌中，高脂联素-2 表达与高 Fuhrman 分级（p<0.001）、肿瘤直径大于 7cm（p=0.007）、TNM 分期升高（p<0.001）和淋巴结转移（p=0.009）相关。在乳头状肾细胞癌的单变量和多变量 Cox 生存分析中，中位随访 49.1 个月（范围 7 至 136）后，脂联素-2 表达与总生存（HR 4.10，95%CI 1.19-14.14，p=0.026）和无病生存（HR 2.56，95%CI 1.01-6.48，p=0.047）降低相关。
脂联素-2 过表达可能是乳头状肾细胞癌总生存和无病生存降低的预后因素。脂联素-2 过表达与乳头状肾细胞癌不良预后的相关性可能具有潜在的诊断和治疗效用。
