Expression And Significance Of PD-1 In Upper Urinary Calculi Complicated With Renal Cell Carcinoma

OBJECTIVE: Kidney cancer is a common malignancy in urology.Patients with kidney cancer complicated with upper urinary calculi observed in clinical work have also increased year by year.Therefore,it is necessary to summarize the clinical data of such patients,analyze its pathogenesis,improve the clinical diagnosis and treatment of such patients,reveal its possible pathogenic mechanism,and better guide clinical work.METHOD:The study is divided into two parts.The first part is a retrospective analysis of clinical data.The data of renal cancer cases collected in our hospital from 2015 to 2018 were collected.According to whether the stones were divided into stone group and non-calculus group,the experience of diagnosis and treatment was summarized..The second part is the clinical basic experimental part.The paraffin specimens of the above cases were collected,and the expression of PD-1 in renal cell carcinoma was studied by immunohistochemistry.RESULT: After analyzing the clinical data of 54 patients in the stone group and 133 patients in the non-stone group,it was found that the upper urinary calculi combined with renal cancer accounted for 28.9% of the kidney cancer diagnosed in the same period.There were no significant differences in gender,age,living environment,diabetes,hypertension,tumor location and size,tumor stage,and differentiation between the two groups.There were statistical differences in clinical symptoms,urinary tract infection,impaired renal function,and hydronephrosis.72.22% of patients had clinical symptoms in the stone group,38.39% of urinary tract infections,29.63% of renal function impairment,and 59.26% of pyelonephrosis.In the clinical basic experimental part,considering the occurrence and development of renal cancer is related to autoimmune response.IHC was used to detect the expression of immunosuppressive protein PD-1 in renal cell carcinoma,and to explore its relationship with urinary calculi and tumor types.By immunohistochemical analysis,PD-1 was expressed in both the stone group and the non-calculus group,but the positive expression rate was not statistically different.It was expressed in cc RCC,p RCC and UTC,and the positive expression rate was statistically significant,with the highest positive expression rate in cc RCC.CONCIUSION:1.Patients with upper urinary tract stones,when combined with urinary tract infection,renal effusion or impaired renal function,should be alert to the possibility of kidney cancer.2.Upper urinary tract stones combined with renal cancer are easily missed,especially when combined with renal pelvis-derived tumors.3.The expression of PD-1 in renal cell carcinoma is related to the histopathological type,with the highest positive rate of cc RCC;no significant correlation with the presence or absence of stones.