Expression Of CXCL12 And CXCR4 In Clear Cell Renal Cell Cancer And Its Corresponding Metastatic Lymph Node

Objective:Renal cell carcinoma(RCC) is the second largest urinry cancer. It is arising trend in the incidence in recent years.Early symptoms of RCC is not obvious.Their metastasis mainly through lymphatic and hematogenous.However,the current reatment of RCC is radical surgery,but have high of recurrence .The results of radiotheraphy and chemotherapy are poor,needing for other effective treatment.The discovery of molecular genetics,to find new and effective method of treating RCC,provide theoretical basis in recent years.The occurrence,development and metastasis are extremely complex process,which involoved many tumor-associated factors participate and control,pathogenesis is not clear. chemokine receptor( CXCR4 ) as only receptor of strornal cell derived factor-1(SDF-1 or CXCL12).Studies suggest that CXCR4 has an important role in rumor-specificmetastasis. Clear cell renal cell carcinoma(CCRCC)is the most common pathological type of RCC. This study investigated that the expression and clinical significance of CXCL12 and CXCR4 in CCRCC.It may be provide a theoretical basis of diagnosing and treating for RCC.M ethods:Collected 53 cases from patients with surgical specimens ,26 cases corresponding metastatic lymph node specimens and randomly selecte 20 cases of peri-cancerous renal specimens from 53 cases.All specimens were fixed in formalin and they had been confirmed by pathology. None of the cases for radiotherapy and chemotherapy. The expression of CXCL12 and CXCR4 was checked in 53 cases of CCRCC ,26 cases corresponding metastatic lymph node specimens and 20 cases of peri-cancerous renal specimens on the protein level by Immunohistochemical methed.The corelation between them and clinical stage,pathological grade, lymphatic m etastasis ,age,sex and tumor size were analyzed.Results The expression rate of CXCR4 in 53 cases clear cell renal cell cancer was 62.2% (33/53);but in 20 peri-cancerous renal specimens,there were only 6 positive cases(30%)。There were more significant differences(P=0.014). The expression rate of CXCR4 in 26 cases clear cell renal cell cancer corresponding metastatic lymph nod was 69.2%(18/26).The expression rate of CXCR4 in metastatic lymph nod is higher than clear cell renal cell cancer primary lesions,but there was no difference in statistics ( P=0.543 )。In well differentiated(low grade), moderate differentiated(medium grade) and poor differentiated(hige grade ) clear cell renal cell cancer histological grade, CXCR4 protein expression were 36.8%,72.7%,83.3% respectively,the higher with increase of pathological grade, there were more significant differences(P<0.05). InⅠ～ⅡandⅢ～Ⅳclear cell renal cell cancer AJCC stage, CXCR4 protein expression were 46.2% and 77.8%,the higher with increase of pathological stage, there were more significant differences(P<0.05). In the groups with and without lymph nodes metastases,the positive rate were 76.9% and 48.1% respectively,the difference between the two groups was significan(tP<0.05). CXCR4 was not related to the patientage,sexuality and tumor diameter(P>0.05). The expression rate of CXCL12 in 53 cases clear cell renal cell cancer was 35.8%(19/53),and in 20 peri-cancerous renal specimens was 45.0%(9/20); but there was no difference in statistic(sP=0.473). The expression rate of CXCL12 in 26 cases clear cell renal cell cancer corresponding metastatic lymph node specimens was 76.9%(20/26).The expression rate of CXCL12 in metastatic lymph node specimens is higher than clear cell renal cell cancer primary lesions,there were more significant differences(P=0.001). The expression rate of CXCL12 in clear cell renal cell cancer was not related to the patientage,sexuality, tumor diameter, clinical stage and histologic grade (P>0.05). Pearson correlation analysis supports a positive correlation between CXCL12 and CXCR4 in metastatic lymph node specimens of clear cell renal cell cancer (r=0.392,P=0.030).Conclusion The expression of CXCR4 was relevant to lymph node status ,clinical stage and histologic grade,High expression of CXCR4 possibly may improve the genesis and development of clear cell renal cell cancer,and can be used as an important prognostic index of clear cell renal cell cancer. The overexpression of CXCL12 and CXCR4 in metastatic lymph node specimens of clear cell renal cell cancer, The coexpression of CXCL12 and CXCR4 may play cooperation role in lymph node metastasis of lear cell renal cell cancer.