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目的探讨基质细胞衍生因子-1(SDF-1)、趋化因子受体4(CXCR4)和血管内皮生长因子(VEGF)在小儿肾母细胞瘤中的表达及其与临床特征的关系。方法收集郑州大学第一、三附属医院2003年5月-2008年5月手术切除经病理证实为肾母细胞瘤的石蜡标本30例。男13例,女17例;年龄4个月～7岁。其中预后良好组织型22例;预后不良组织型8例,以细胞质染成棕黄色为阳性细胞,以染色强度和阳性瘤细胞百分比的乘积作为阳性和阴性判断标准。对照组12例取瘤旁正常肾组织标本。2组均行HE染色,采用SPSS13.0软件进行统计学分析。结果VEGF、CXCR4和SDF-1在肾母细胞瘤中的阳性表达率分别为63.33%、70.0%、53.33%,而在瘤旁正常肾组织中的阳性表达率分别为25.0%、8.3%、16.7%。VEGF、CXCR4和SDF-1在肾母细胞瘤中的表达均明显高于瘤旁正常肾组织(Pa<0.05),3者在临床分期Ⅲ～Ⅳ期和预后不良组织型组及有淋巴转移组的肾母细胞瘤中的表达明显高于在临床分期Ⅰ～Ⅱ期和预后良好组织型及无淋巴结转移的肾母细胞瘤中的表达(Pa<0.05)。相关分析显示CXCR4与VEGF、SDF-1的阳性表达均呈正相关,SDF-1与VEGF的阳性表达亦呈正相关。肾母细胞瘤中CXCR4、SDF-1和VEGF的表达与肿瘤的淋巴结转移、病理分型及临床分期有相关性,而与性别无相关性。结论VEGF、SDF-1及CXCR4与肾母细胞瘤的发展、预后有关,参与了肿瘤血管的生成及肿瘤的增殖侵袭,对于评估患儿预后及靶向治疗肾母细胞瘤具有一定意义。
Objective To investigate the expression of SDF-1, CXCR4 and VEGF in pediatric nephroblastoma and its relationship with clinical features. Methods The first and third affiliated hospitals of Zhengzhou University were collected from May 2003 to May 2008, and 30 cases of pathologically confirmed nephroblastoma were collected. 13 males and 17 females; aged 4 months to 7 years old. The prognosis was good tissue type in 22 cases; the poor prognosis tissue type in 8 cases, with cytoplasm stained brown positive cells, the staining intensity and the percentage of positive tumor cells as the positive and negative criteria. The control group of 12 cases of normal renal tissue specimens. 2 groups were HE staining, using SPSS13.0 software for statistical analysis. Results The positive rates of VEGF, CXCR4 and SDF-1 in nephroblastoma were 63.33%, 70.0% and 53.33%, respectively. The positive rates of VEGF, CXCR4 and SDF-1 in neoplastic tissues were 25.0%, 8.3% and 16.7 %. The expressions of VEGF, CXCR4 and SDF-1 in nephroblastoma were significantly higher than those in the adjacent normal tissues (P <0.05). The expressions of VEGF, CXCR4 and SDF-1 were significantly higher in the neoplastic stage than in the neoplastic stage Of nephroblastoma was significantly higher than that in stage Ⅰ ~ Ⅱ clinical stage and with good prognosis and nephroblastoma without lymph node metastasis (P <0.05). Correlation analysis showed that there was a positive correlation between the expression of CXCR4 and VEGF, SDF-1, and the positive expression of SDF-1 and VEGF. The expression of CXCR4, SDF-1 and VEGF in Wilms’ tumor was correlated with lymph node metastasis, pathological type and clinical stage of neoplasia, but not with gender. Conclusions VEGF, SDF-1 and CXCR4 are related to the development and prognosis of nephroblastoma. They are involved in the generation of tumor blood vessels and the proliferation and invasion of neoplasms. They are of great significance in evaluating the prognosis of children and targeting nephroblastoma.