P.A. Hertsen Moscow Oncology Research Institute - Branch of the Federal State Budgetary Institution "National Medical Research Radiological Centre", Ministry of Health of the Russian Federation.
N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation.
Klin Lab Diagn. 2021 Sep 10;66(9):517-524. doi: 10.51620/0869-2084-2021-66-9-517-524.
KIM-1 (kidney injury molecule 1), a marker of acute kidney injury, is produced by epithelial cells of renal proximal tubules. Elevated KIM-1 levels in urine and plasma are associated with renal cell carcinoma (RCC). The aim of this study was to compare the significance of non-normalized uKIM-1 values and those normalized to urine creatinine, as urinary biomarkers in RCC. The uKIM-1, urine creatinine and their ratio (uKIM-1/Cre) were studied in 118 RCC patients and 58 apparently healthy subjects. The median of uKIM-1 in the healthy group was 0.71 ng/ml (1st and 3rd quartiles were 0.35 and 1.23, respectively) and in RCC patients it was 2.36 (1.43; 5.93) ng/ml. The medians of uKIM-1/Cre were 0.77 (0.49; 1.18) and 2.42 (1.41; 4.61) ng/mgCre, respectively. Stage I RCC is statistically significantly different from stages II-III and stage IV using uKIM-1/Cre values (p = 0.0056 and p = 0.0012, respectively); using uKIM-1 values significant differences occur only when comparing stages I and IV (p = 0.015). In both healthy individuals and RCC patients, uKIM-1/Cre levels were slightly lower in subgroups younger than 50 years than in subgroups older than 50 years, whereas a similar trend was observed for uKIM-1 only in patients. In healthy men and male patients, uKIM-1 levels were higher than in the corresponding groups of women (the differences were not statistically significant), but the use of uKIM-1/Cre values eliminated the gender differences. A high correlation was found between the concentrations of uKIM-1 and urine creatinine in three healthy subjects followed up for 3 weeks (Spearman's correlation coefficients were 0.758, 0.825 and 0.933, respectively). The data obtained are clear evidence of the need for normalization uKIM-1 to urine creatinine in RCC patients.
肾损伤分子 1（KIM-1）是近端肾小管上皮细胞产生的急性肾损伤标志物。尿液和血浆中 KIM-1 水平升高与肾细胞癌（RCC）有关。本研究旨在比较非标准化 uKIM-1 值与标准化至尿肌酐的 uKIM-1 值作为 RCC 的尿液生物标志物的意义。在 118 例 RCC 患者和 58 例貌似健康的受试者中研究了 uKIM-1、尿肌酐及其比值（uKIM-1/Cre）。健康组 uKIM-1 的中位数为 0.71ng/ml（1 四分位数和 3 四分位数分别为 0.35 和 1.23ng/ml），RCC 患者为 2.36ng/ml（1.43；5.93ng/ml）。uKIM-1/Cre 的中位数分别为 0.77ng/mgCre（0.49；1.18ng/mgCre）和 2.42ng/mgCre（1.41；4.61ng/mgCre）。使用 uKIM-1/Cre 值时，I 期 RCC 与 II-III 期和 IV 期有统计学显著差异（p=0.0056 和 p=0.0012）；仅当比较 I 期和 IV 期时，uKIM-1 值才有显著差异（p=0.015）。在健康个体和 RCC 患者中，50 岁以下亚组的 uKIM-1/Cre 水平略低于 50 岁以上亚组，而仅在患者中观察到 uKIM-1 的相似趋势。在健康男性和男性患者中，uKIM-1 水平高于相应的女性组（差异无统计学意义），但使用 uKIM-1/Cre 值消除了性别差异。在 3 名随访 3 周的健康受试者中，uKIM-1 浓度与尿肌酐之间存在高度相关性（Spearman 相关系数分别为 0.758、0.825 和 0.933）。获得的数据清楚地证明了在 RCC 患者中需要将 uKIM-1 标准化至尿肌酐。
