| Background and ObjectiveNephroblastoma also known as Wilms' tumor is among babies and infants,the most common abdomen malignant entity tumor,and is also called the kidney embryoma tumor.It is also the most common uropoiesis tumor in young children, making up 80% in the uropoiesis tumor below 15 years old children and 8% in the abdomen entity tumor of young children.In recent years by surgery, chemotherapy, radiotherapy and other comprehensive therapies, the prognosis of Wilms' tumor is most ideal in the child malignant entity lump at present, and the long-term survival rate of Wilms' tumor has been distincly enhanced.But there still has some patients who were dead because of the tumor recrudescence.Therefore,a discussion of the infiltration shift mechanism of Wilms' tumor,can make the early diagnosis.The early discovery of the recrudescence of the Wilms' tumor has the vital significance in the prognosis of Wilms' tumor.In recent years inflammation medium High mobility group box chromosomal protein 1 (HMGB1) and ligand receptor foradvanced glycation end products (RAGE) have already brought to everybody's attention in the tumor infiltration shift's function, and there are literatures reporting about its function in oral cancer, stomach cancer, breast cancer, cervical cancer, lung cancer, colon cancer, cancer of the pancreas and so many other kinds of tumor growths, infiltration, shift. Vascular endothelial growth factor (VEGF) have now considered is an important factor during the generating of tumor vascular and playing an important role in the tumor metastasis through vascular. The discussion of the expressions of HMGB1, RAGE and VEGF in the Wilms' tumor organizations and in the tumor blood vessel infiltrates and in the lymph node shift, has the vital significance to the prognosis of Wilms' tumor.MethodFifty cases of Wilms' tumor samples which had been confirmed by pathology were collected from the First Affiliated Hospitals of Zhengzhou University from January 2003 to January 2010.And 15 cases were taken from the adjacent kidney tissues at the same period time.Other 7 cases were normal kidney tissues.The expression of HMGB1, RAGE and VEGF were detected by the Immunohisto-chemical SP staining in each group of specimens. The positive rate of HMGB1, RAGE and VEGF were analyzed through x2 test and Fisher's test. The SPSS 13.0 softwares is to be used to analysis the data. The expressions of HMGB1, RAGE and VEGF in tumor tissues were measured by average integrated optical density. The expression intensity was analyzed by computer image processing and their significances in each group of specimens were studied.By means of value±standard deviation expression.Using T-test comparison group difference,and the relevance are to be based on the pearson relevance analysis, Kaplan-Meiermethod and the Long-rank examination are to be used in the evaluation of survival rates and Examination standard is a=0.05.Result1 The expressions of HMGB1 in the Wilms' tumor group, the adjacent kidney tissues and the normal kidney tissues50 cases of the Wilms' tumor specimen of this research, the positive rate of HMGB1 in tumor body group,in nearby tumor group and normal kidney organization group respectively is:72%,33.3%,14.2%. There was a significant difference between the Wilms' tumor group and the adjacent kidney tissues or in the normal kidney tissues (P<0.05). The expressions of HMGB1 in the adjacent kidney tissues and in the normal kidney were no significantly different (P>0.05).The expressions of HMGB1 proteins in Wilms' tumor tissues of stageⅢ～Ⅳand high risk histopathol-ogy and lymph node metastasis group (163.14±7.50,169.17±4.42,163.83±7.20) were significantly higher than those of stageⅠ～Ⅱand low risk histopathology and no lymph node metastasis group (139.23±5.83,139.52±5.22,138.61±5.59) (P<0.05). There is no correlation between the expressions of HMGB1 in Wilms' tumor tissues and the patient's sex or the tumor's size (P>0.05). The survival rate of children whose HMGB1 expressed positive is significantly below than the children whose HMGB1 expressed negative (P< 0.05)2 The expressions of RAGE in Wilms'tumor group, the adjacent kidney tissues and the normal kidney tissues50 cases Wilms' tumor specimem of this research, the positive rate of RAGE in tumor body group,nearby tumor group and normal kidney organization group repectively is:84%,53.3%, O.There was a significant difference between the Wilms' tumor group and the adjacent kidney tissues or in the normal kidney tissues (P< 0.05). The expressions of RAGE in the adjacent kidney tissues and in the normal kidney were also significantly different (P<0.05). The expressions of RAGE proteins in Wilms' tumor tissues of stageⅢ～Ⅳand high risk histopathology and lymph node metastasis group (147.73±6.71,155.29±3.97,151.56±5.46) were significantly higher than those of stageⅠ～Ⅱand low risk histopathology and no lymph node metastasis group (133.30±11.23,135.39±9.71,133.00±8.75) (P<0.05).There is no correlation between the expressions of RAGE in Wilms' tumor tissues and the patient's sex or the tumor's size (P>0.05). The survival rate of children whose RAGE expressed positive is significantly below than the children whose RAGE expressed negative (P< 0.05)3 The expressions of VEGF in Wilms'tumor group, the adjacent kidney tissues and the normal kidney tissues50 cases Wilms' tumor specimen of this research, the positive rate of VEGF in tumor body group, in nearby tumor group and normal kidney organization group repectively is:76%,40%,14.2%. There was a significant difference between the Wilms' tumor group and the adjacent kidney tissues or in the normal kidney tissues (P <0.05). The differences between the expressions of VEGF in the adjacent kidney tissues and in the normal kidney tissues were not be seen (P>0.05). The expressions of VEGF proteins in Wilms' tumor tissues of stageⅢ-Ⅳand high risk histopathol-ogy and lymph node metastasis group (163.14±7.50,169.17±4.42,163.83±7.20) were significantly higher than those of stageⅠ～Ⅱand low risk histopathology and no lymph node metastasis group (140.85±8.87,143.94±10.39,141.18±8.95) (P<0.05). The correlations between the expressions of VEGF in Wilms' tumor tissues and the patient's sex or the tumor's size were not be seen (P>0.05). The survival rate of children whose VEGF expressed positive is significantly below than the children whose VEGF expressed negative (P<0.05)4 The relevant analysis of the expressions of HMGB1 RAGE and VEGF in the Wilms'tumor tissuesAmong 50 cases Wilms' tumor specimen of this research, there was a positive correlation between the expressions of HMGB1 with RAGE(r=0.424,P=0.002);and there was a positive con-elation between the expressions of HMGB1 with VEGF too(r=0.453,P=0.001);but the correlation between the RAGE and VEGF is not clear(r=0.237,P=0.101).Conclusion1. There is a high expression of HMGB1,RAGE and VEGF in Wilms' tumor tissues, and their high expression effect the prognosis of Wilms' tumor.2. The expressions of HMGB1,RAGE and VEGF were significanly different between different clinical stages, and pathology organization type in Wilms' tumor tissues, indicating that they have a vital role in the occurrence and development of Wilms' tumor.3. The expressions of HMGB1,RAGE and VEGF in the lymph node metastasis group were significantly higher than those of no lymph node metastasis group, and there was a positive correlation between the expressions of HMGB1 with RAGE and HMGB1 with VEGF, thus indicating that they promote the lymph node shifting in the Wilms' tumor cooperation.4. HMGB1, RAGE and VEGF play a vital role in the lymph node shifting and vascularization of Wilms' tumor. The examination of the expressions of HMGB1, RAGE and VEGF is helpful in the prognosis forecast of Wilms' tumor. |
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