肾透明细胞癌尿液中锌指蛋白转录因子4的表达及临床意义

Expression and clinical significance of KLF4 in the urine of patients with clear cell renal cell carcinoma

摘要:

目的：探讨肾透明细胞癌尿液脱落细胞中锌指蛋白转录因子4（Krüppel-like factor 4，KLF4）的表达及临床意义。方法：分别收集58例术后病检证实为肾透明细胞癌的肾癌患者及40例健康志愿者尿液。采用RT-PCR技术检测KLF4 mRNA的表达率，Western blot检测KLF4蛋白的表达率；分析KLF4因子的表达与肾透明细胞癌患者临床病理参数的关系。结果：肾透明细胞癌患者尿液脱落细胞KLF4表达明显下调，肾透明细胞癌组KLF4表达阴性率为87.9%（51/58），表达阳性率仅12.1%；而对照组KLF4表达阴性率为7.50%（3/40），表达阳性率为92.5%，2组表达阴性率比较有统计学差异（P<0.05）。肾癌患者中KLF4表达下调与患者年龄（ χ2=0.369，P=0.544）、性别（ χ2=0.705，P=0.401）、肿瘤大小（ χ2=3.481，P=0.062）、肾透明细胞癌患者的临床分期（ χ2=0.762，P=0.859）、组织分化程度（ χ2=0.064，P=0.996）、淋巴结转移（ χ2=0.301，P=0.583）均无关。结论：检测尿液KLF4因子可能有助于肾透明细胞癌的诊断及术后监测。RT-PCR为临床可行的检测方法。

Abstract:

Objective：To investigate the expression and clinical significance of Kruppel-like factor 4（KLF4） in the urine exfoliated cells of patients with clear cell renal cell carcinoma（CCRCC）. Methods：Urine samples were collected from 58 patients pathologically confirmed to have CCRCC after operation and 40 healthy volunteers. The expression rate of KLF4 mRNA was determined by RT-PCR，and the expression rate of KLF4 protein was determined by Western blot. The relationship between the expression of KLF4 and the clinicopathological parameters of CCRCC patients was analyzed. Results：The expression of KLF4 in the urine exfoliated cells of CCRCC patients was down-regulated significantly. In the CCRCC group，the negative rate of KLF4 expression was 87.9%（51/58），while the positive rate of its expression was only 12.1%；in the control group，the negative rate of KLF4 expression was 7.50%（3/40），while the positive rate of its expression was 92.5%；there was a significant difference in the negative rate of KLF4 expression between the two groups（P<0.05）. The down-regulation of KLF4 in CCRCC patients was not associated with age（ χ2=0.369，P=0.544），sex（ χ2=0.705，P=0.401），tumor size（ χ2=3.481，P=0.062），clinical stage（ χ2=0.762，P=0.859），degree of tissue differentiation（ χ2=0.064，P=0.996），and lymph node metastasis（ χ2=0.301，P=0.583）. Conclusion：The detection of urine KLF4 may be helpful to the early diag－nosis and postoperative monitoring of CCRCC，and RT-PCR is a feasible detection method in clinical practice.