摘要目的:探讨纤维蛋白原样蛋白1（FGL1）在透明细胞性肾细胞癌（ccRCC）中的表达及其与患者临床病理特征的相关性。方法:回顾性分析2015年1月至2018年12月确诊并接受手术治疗的242例ccRCC患者的临床病理资料，收集患者癌组织和癌旁组织（距离癌组织边缘2 cm）。采用免疫组织化学法检测FGL1蛋白的表达情况，应用反转录-聚合酶链反应（RT-PCR）检测FGL1 mRNA的相对表达量，采用Cox比例风险模型对患者无进展生存（PFS）的影响因素进行单因素及多因素分析。结果:癌组织中FGL1蛋白阳性率高于癌旁组织[28.5%（69/242）比2.1%（5/242）]，差异有统计学意义（ χ2=65.34， P<0.001）；癌组织中FGL1 mRNA相对表达量亦高于癌旁组织（1.67±0.12比0.60±0.15），差异有统计学意义（ t=25.33， P<0.001）。FGL1的表达与病理分期（ r=0.164， P=0.011）、肾血管瘤栓（ r=0.130， P=0.043）、区域淋巴结转移（ r=0.153， P=0.018）和远处转移（ r=0.160， P=0.012）均呈正相关。单因素分析显示，肿瘤长径、区域淋巴结转移、病理分期、远处转移、FGL1表达均为患者PFS的影响因素（均 P<0.05）；多因素分析显示，FGL1高表达（ HR=11.679，95% CI 7.432~15.673， P=0.015）、病理分期Ⅲ~Ⅳ期（ HR=13.654，95% CI 8.765~18.761， P=0.013）、远处转移（ HR=11.387，95% CI 7.662~14.831， P=0.038）均为患者PFS的独立危险因素。 结论:FGL1在ccRCC中高表达，且与病理分期、肾血管瘤栓、区域淋巴结转移和远处转移具有相关性，是影响患者预后的独立危险因素。

abstractsObjective:To investigate the expression of fibrinogen-like protein 1 (FGL1) in clear cell renal cell carcinoma (ccRCC) and its correlation with clinicopathological characteristics of patients with ccRCC.Methods:The clinicopathological data of 242 patients with ccRCC who were diagnosed and treated surgically from January 2015 to December 2018 were retrospectively analyzed. The cancerous tissues and paracancerous tissues (2 cm away from the edge of cancerous tissues) of patients were collected. The expression of FGL1 protein was detected by using immunohistochemistry, and the relative expression level of FGL1 mRNA was detected by using reverse transcription polymerase chain reaction (RT-PCR). Cox proportional risk model was used to make univariate and multivariate analysis of the influencing factors of progression-free survival (PFS).Results:The positive rate of FGL1 protein in ccRCC tissues was higher than that in paracancerous tissues [28.5% (69/242) vs. 2.1% (5/242)], and the difference was statistically significant ( χ2 = 65.34, P < 0.001); the relative expression level of FGL1 mRNA in ccRCC tissues was higher than that in paracancerous tissues (1.67±0.12 vs. 0.60±0.15), and the difference was statistically significant ( t = 25.33, P < 0.001). The expression of FGL1 was positively correlated with pathological staging ( r = 0.164, P = 0.011), renal vascular tumor thrombus ( r = 0.130, P = 0.043), regional lymph node metastasis ( r = 0.153, P = 0.018), and distant metastasis ( r = 0.160, P = 0.012). Univariate analysis showed that the tumor diameter, regional lymph nodes metastasis, pathological staging, distant metastasis, and FGL1 expression were factors influencing the PFS of ccRCC patients (all P < 0.05). Multivariate regression results showed that high expression of FGL1 ( HR = 11.679, 95% CI 7.432-15.673, P = 0.015), pathological staging of Ⅲ-Ⅳ ( HR = 13.654, 95% CI 8.765-18.761, P = 0.013), and distant metastasis ( HR = 11.387, 95% CI 7.662-14.831, P = 0.038) were independent risk factors for PFS in patients. Conclusions:FGL1 is highly expressed in ccRCC, which is correlated with pathological staging, renal vascular tumor thrombus, regional lymph nodes metastasis, and distant metastasis. The high expression of FGL1 is a risk factor affecting the prognosis of patients with ccRCC.