| Objective To investigate the expression and significance of E-cadherin and P-catenin in renal angiomyolipoma(AML)with different histological subtypes,To improve the understanding of epithelioid angiomyolipoma.Methods From January 2001 to December 2015,117 cases of renal AML confirmed by immunohistochemistry were retrospectively analyzed from National cancer center/Chinese academy of medical sciences Peking Union Medical College cancer hospital,including 97 cases of typical AML and 20 cases of EAML.The clinical pathological data of patients were collected,The proportion,nuclear heterogeneity and growth pattern of epithelioid cells were evaluated by tissue microarray and the expression of E-cadherin and ?-catenin and six other antibodies(HMB-45?Melan-pan?Melan-A?AE1/AE3?CK-18?S-100)in tumor tissues were detected by immunochemical staining with microarray,and the survival of the EAML groups were analyzed.Results In total 117 with 33 males and 84 females,Ratio of 0.39:1,the median age was 49(20-77).typical AML group with29 males and 68 females,Ratio of = 0.43:1,EAML group with 4 males and 16 females,Ratio of =0.25:1.Missing tissue sections were removed.The positive rates of E-cadherin and ?-catenin expression were 80.6%(79/98)and 82.3%(79/96)respectively.Their co-expression rate was 76.6%(72/94).The expression rates of epithelial markers AE1/AE3 and CK-18 were 0%(0/110,0/106),and the expression rates of S-100 were 58.7%(64/109),while the expression rates of melanoma tumor markers HMB-45,Melan-pan and Melan-A were 96.6%(113/117),90.0%(97/109)and 88.2%(97/110),respectively.The positive expression rates of E-cadherin and?-catenin in typical AML tissues were 78.75%(63/80),80.0%(64/80),and 88.9%(16/18)and 93.75%(15/16)respectively in EAML tissues.The expression intensity of E-cadherin and ?-catenin was higher in EAML.Although the expression intensity of E-cadherin was not statistically significant in the two subtypes of tissues(P=0.0583),the expression intensity of ?-catenin was statistically significant in the two subtypes of tissues(P=0.0333).The expression rates of S-100,HMB-45,Melan-pan and Melan-A in the two subtypes of tissues were respectively 58.7%(7/18)and 62.6%(57/91),100%(19/19)and 93.6%(88/94),100%(19/19)and 86.7%(78/90),88.9%(16/18)and 88.0%(81/92),with no significant statistical difference(P>0.05).E-cadherin was mainly located in the cytoplasm through the typical AML,while EAML was mainly located in the cell membrane with the cytoplasm,and there was a statistical difference(P=0.0142)between them.The protein expressions of E-cadherin and ?-catenin in all cases were correlated with Melan-A and Melan-pan(P<0.0001).Two groups of patients were followed up for a long time.A median follow-up period of 69.3 months(25.7-220.1 months)was performed in 97 patients with typical renal AML,with no recurrence,metastasis or death.In the EAML group,20 patients were followed up for a median of 85.5 months(30.7-193.2 months),among which one patient developed liver and pelvic metastasis and died after multiple surgeries and chemotherapy,with a survival time of 42 months.No tumor recurrence or metastasis occurred in the remaining patients.Conclusions Renal AML is more common in women,both typical and epithelial types.Epithelioid types can present recurrence and metastasis,and the prognosis of metastatic patients is poor.Histopathological findings can be based on subcellular localization of E-cadherin protein expression and expression of ?-catenin to assist in the diagnosis of typical and epithelial AML,but need to be verified by larger sample studies. |
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