摘要目的 明细胞癌、乳头状肾细胞癌、肾嫌色细胞癌、Xp11.2易位/TFE3基因融合相关性肾癌和转移性透明细胞癌中的表达率分别是77.8%(49/63)、90.9%(20/22)、1/13、7/7和87.5%(21/24),7例嗜酸细胞腺瘤均阴性.在原发性肾透明细胞癌中,KIM-1弥漫阳性表达更易发生于Furhman细胞核Ⅲ/Ⅳ级的病例(P=0.010).肾特异性钙黏蛋白主要表达于嫌色细胞癌和嗜酸细胞腺瘤.结论 KIM-1仅表达于损伤的近曲小管和由其起源的肿瘤,对原发性和转移性肾透明细胞癌、乳头状肾细胞癌及Xp11.2易位/TFE3基因融合相关性肾癌具有高度的特异性和敏感性,与肾特异性钙黏蛋白合用可以提高原发性肾脏上皮性肿瘤组织学分类的准确性和转移性肾透明细胞癌的诊断率.

abstractsObjective To study the expression and clinical significance of kidney injury molecule-1 (KIM-1 ) in primary and metastatic renal epithelial neoplasms. Methods A total of 136 cases of kidney neoplasms were retrospectively reviewed including 63 primary clear cell renal cell carcinomas ( RCCs) , 22 papillary RCCs, 13 chromophobe RCCs, 7 oncocytomas, 7 RCCs associated with Xp11. 2 translocation/ TFE3 gene fusions and 24 metastatic clear cell RCCs. Immunostaining for KIM-1 and kidney-specific-protein (Ksp)-cadherin were performed and the relationship to tumor stage and grade in clear cell RCCs was investigated. Results Expression of KIM-1 was detected in 77. 8% (49/63) of clear cell RCCs, 90. 9% (20/22) of papillary RCCs, 1/13 of chromophobe RCCs, 7/7 of RCCs associated with Xp11. 2 translocation/TFK3 gene fusions and 87. 5% (21/24) of the metastatic RCCs, but not detected in 7 cases of oncocytomas. A diffuse expression of KIM-1 was more frequently observed in Furhman nuclear grade Ⅲ/Ⅳ clear cell RCCs (P = 0. 010). Ksp-cadherin expression was mainly observed in chromophobe RCCs and oncocytomas. Conclusions KIM-1 is a specific biomarker for injuried kidney proximal tubules and the corresponding neoplasms, and has a high specificity and sensitivity for primary or metastatic clear cell RCCs, papillary RCCs and RCCs associated with Xp11. 2 translocation/TFE3 gene fusions. Combination of KIM-1 and Ksp-cadherin immunostaining can lead to a more precise histological classification of primary kidney epithelial neoplasms and improve the diagnostic accuracy of metastatic RCCs.