| The incidence of kidney cancer accounts for about3%of the adult malignant tumor, which is in thesecond in urinary tract tumors be next only to bladder cancer and70%-80%of it is renal clear cellcarcinoma. For many years, the radical nephrectomy (RN) was the commentest surgery treatment forlocalized renal cell carcinoma. With the development of imaging diagnostic techniques, operation methods,basic study of prevention of ischemia-reperfusion injury and monitoring and management conditions aftersurgery, partial nephrectomy(PN) in kidney cancer treatment get an increasingly application. It is reportedthat full nephrectomy is a significant independent risk factors of chronic kidney disease occurredpostoperatively in patients with early renal tumor. Therefore RN should no longer be as the gold standard inthe treatment of early renal tumors. For early kidney cancer, there are more and more research about theapplication of PN in phase T1b renal cancer. However, what is the safe resection margin? Now there arelew researches about this aspect.Objective: To screen different expression of PCNA and Bax between kidney cancer tissue and normalrenal tissue which of different distances adjacent to carcinoma and preliminary discuss the safe resectionmargin of phase T1b renal cancer.Methods: From July2011to July2012, Shihezi University School of Medicine, First Affiliated Hospital ofT1b renal cancer patients,21cases with RN therapy experience were collected for tumor tissue supply, andwith pathological diagnosis of renal clear cell carcinoma. A total of85pieces was got in cancer up, down,left, right, bottom, and each including carcinoma tissue specimens (group A), and cancer by0.2cm (groupB),0.5cm (group C),1.0cm (group D) of normal kidney tissues. Volume of each pieces is2.0×1.0×0.2cm3.Expression of PCNA and Bax was re-evaluated by conventional HE staining and immunohistochemistry.The outcomes were analyzed by SPSS17.0.Results:21cases of T1b renal cancer were all clear cell carcinoma, the mean diameter is4.8±0.97cm.85pieces of tissue samples, the envelope not seen cancer cell invasion,81(95.3%); envelope0.2cm seecancer cell invasion,3(3.5%), envelope0.5cm infiltrate1piece.The expression of PCNA in renalcarcinoma was68.2%, It was significantly higher than that in adjacent tissues (A/B, A/C, A/D, P <0.05).The expression of PCNA in0.5,1.0cm tissue beside carcinoma was obviously lower than that of0.2cmtissue beside carcinoma (P <0.05). It is not obvious difference during the rest groups. The expression ofBax protein in renal carcinoma was18.8%, It was significantly lower than that in adjacent tissues (A/B,A/C, A/D, P <0.05), The expression of Bax protein in0.5,1.0cm tissue beside carcinoma was obviouslyhigher than that of0.2cm tissue beside carcinoma (P <0.05). It is not obvious difference during the restgroups.Conclusion:1.The safety margin in partial nephrectomy for the T1b stage renal carcinoma is at least0.5cmof normal parenchyma tissue beyond the pseudocapsule of the tumor. |
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