| ObjectivesCathepsin K expression was observed in Xp11.2 translocation renal cell carcinoma, analyze the relationship between its expression and clinical characteristics, discuss the value of diagnosis and prognosis.Methods65 cases renal cell carcinoma paraffin block specimens were collected from January 2006 to March 2013 at the Affiliated Drum Tower Hospital of Nanjing University Medical School that under 45 years or pathology Suspect Xp11.2 translocation renal cell carcinoma, Clinical and follow-up data were complete, TFE3 and Cathepsin K immunohistochemistry and fluorescence in situ hybridization (FISH) was utilized, FISH positive as diagnostic criteria of Xp11.2 translocation renal cell carcinoma. Analysis the sensitivity, specificity, positive predictive value and negative predictive value of TFE3 and Cathepsin K in the diagnosis of Xp11.2 translocation renal cell carcinoma. Explore the correlation with expression of Cath-K in Xp11.2 translocation RCC clinical features and Prognosis.Results1.6 cases have the obvious histopathology of Xp11.2 translocation RCC in 65 cases of renal cell carcinoma patients, growth in Clear or eosinophils characterized, the tumor cells with abundant cytoplasm, prominent nucleoli, gravel bodies and hyaline nodules, nest-like structure, less cytoplasm,pleomorphic.2. TFE3 positive 24 cases, Cathepsin K positive 16 cases, FISH positive 22 cases in the 65 cases of renal cell cancer.43 cases papillary renal cell carcinoma and Clear cell carcinoma Cathepsin K immunohistochemistry were negative that FISH negative.3.10 of 22 cases Xp11.2 translocation renal cell carcinoma with gross hematuria, in contrast, FISH-negative renal cell carcinoma none of the symptoms of hematuria.4.22 cases Xp11.2 translocation renal cell carcinoma that was diagnosed through FISH,Age from 3 to 51 years old, a median age is 27 years old, less than 45 years old 20 cases, male 9, female 13.5. TFE3 positive 21 cases, Cathepsin K positive 16 cases.TFE3 and Cathepsin K diagnostic Xp11.2 translocation renal cell carcinoma sensitivity is 95.5%(21/22) and 72.7%(16/22), specificity is 93.0%(40/43) and 100%(43/43), the positive predictive value is 87.5%(21/24) and 100%(16/16),negative predictive value is 97.6 (40/41) and 87.8%(43/49).6.22 cases Xpll.2 translocation renal cell carcinoma involve TFE3 and Cathepsin K while positive 16 cases,while negative 1 case,TFE3 positive and Cathepsin K negative 5 cases. United TFE3 and Cathepsin K diagnosis Xp11.2 translocation renal cell carcinoma sensitivity is 94.1%(16/17), specificity is 100% (48/48), positive predictive value is 100%(16/16), negative predictive value is 98.0% (48/49).7. The 5-year survival rate of Xp11.2 translocation RCC was 66.2%, the 5-year survival rate of non-Xp11.2 translocation RCC was 86.5%, the 5-year survival rate was significantly differents (P<0.05).8. Cathepsin K expression in gender and age were not significant differences (P> 0.05), in clinical stage, size, vein thrombosis, metastasis and recurrence, survival were statistically significant differences (P<0.05).9. The 5-year survival rate of Xp11.2 translocation RCC in Age, sex, size, surgical approach were no significant difference (P> 0.05), in clinical stage, vein thrombosis, metastasis, recurrence and Cathepsin K expression were significantly differents (P<0.05).Conclusions1.TFE3 with a high sensitivity and negative predictive value, Cathepsin K with a high specificity and positive predictive value in diagnosis of Xp11.2 translocation renal cell carcinoma. United TFE3 and Cathepsin K can improve the accuracy diagnosis of Xp11.2 translocation renal cell carcinoma. Cathepsin K plays an important role in the diagnosis and differential diagnosis of Xp11.2 translocation RCC.2. Cathepsin K expression in Xp11.2 translocation RCC,5 survival rate, tumor stage, size, thrombus, metastasis and recurrence were significantly differents Cathepsin K plays an important role in the prognosis of Xp11.2 translocation RCC, Cath-K may be therapy targets of Xpl 1.2 translocation RCC. |
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