| Objectives:To study the protein expression of Glucose-6-phosphate Dehydrogenase(G6PD)and Vascular Endothelial Growth Factor(VEGF)in human Clear Cell Renal Cell Carcinoma(CCRCC),and analyze correlation about the two indicators and the clinicopathological data of CCRCC and their relationship with patients' survival time,in order to provide a new reference for diagnosis,targeted therapy and prognosis of kidney cancer patients.Methods:In this study used retrospective case analysis,selected 32 cases of renal cancer patients confirmed in the first affiliated hospital of Kunming medical university between February 2011 and June 2012,all the selected patients were treated with Radical nephrectomy in our hospital,meanwhile,CCRCC was confirmed by pathological examination.The expression of G6PD and VEGF protein in 32 cases of CCRCC tissues samples and the 32 cases of para-carcinoma kidney tissues(renal tissues of 1 cm out side of the tumor pseudocapsule)samples adjacent to cancer were detected by the method of immunohistochemical s-p.According to the clinical indicators and follow-up results of patients,analyzed by the statistical software,the comparison of immunohistochemical results and clinicopathological features was adopted by Chi-squared Test,Kruskal-Wallis Test and Pearson correlation was used to compare the correlation between different groups.According to the method of Kaplan-Meier,Log-rank for survival analysis.Discussed the relationship between G6PD,VEGF and prognosis of CCRCC patients was analyzed by the method of COX proportional risk model.Results:1.The expression of G6PD and VEGF in CCRCC tissues and control group kidney tissues.The positive expression rate of G6PD protein in CCRCC tissues was 68.8%(22/32),and the positive expression rate of G6PD protein in control group kidney tissues was 15.6%(5/32),the difference was statistically significant(P<0.05).The positive expression rate of VEGF protein in CCRCC tissues was 56.3%(18/32),and the positive expression rate of VEGF protein in control group kidney tissues was 21.9%(7/32),the difference was statistically significant(P<0.05).2.The correlation of G6PD and VEGF expression in renal CCRCC tissues.The expression of G6PD and VEGF protein in CCRCC tissues,all of the 18 samples with positive expression of VEGF were positive expression of G6PD,there were 10 samples with negative expression of G6PD in 14 samples with negative expression of VEGF,there was significantly positive correlation between them(r=0.764,P<0.01).3.The expression of G6PD and VEGF in CCRCC tissues and their relationship with clinical data.(1)The positive expression of G6PD in CCRCC tissues was correlated with lymph node metastasis,tumor size,histological classification and TNM staging,the difference was statistically significant(P<0.05).The positive expression of G6PD in CCRCC tissues was not significantly correlated with the gender,age and side of the tumor,the difference was no statistically significant(P>0.05).(2)The positive expression of VEGF in CCRCC tissues was correlated with lymph node metastasis,tumor size and TNM staging,the difference was statistically significant(P<0.05).The positive expression of VEGF in CCRCC tissues was not significantly correlated with the gender,age,side of the tumor and histological classification,the difference was no statistically significant(P>0.05).4.The relationship between the expression of G6PD and VEGF protein in CCRCC and the survival time of patients.The overall survival of CCRCC patients in 5 years,the total survival time(OS)of 32 patients was 1-77 months,deadline was June 2017.Among the 32 cases,15 patients died and 2 cases were lost,the 5-year survival rate was about 53.1%,and the median survival time was about 75 months.There were 11 cases with positive expression of G6PD and VEGF in the 15 patients with death,there were 2 patients with positive expression of G6PD and negative expression of VEGF,there were 2 patients with negative expression of G6PD and VEGF,The mortality of patients with positive expression of G6PD and VEGF(61.1%,11/18)was greater than that of only one gene expression or G6PD and VEGF both negative expression(28.6%,4/14).The 5-year survival rate of G6PD expression positive group and G6PD expression negative group was 40.9%,80.0%,and median survival time was 48.1 months,68.4 months(?2=4.666,P=0.031).The 5-year survival rate of VEGF expression positive group and VEGF expression negative group was 38.9%,71.4%,and median survival time was 40 months,64.4 months(x2=4.014,P=0.045).COX regression analysis showed TNM staging was associated with prognosis of patients(P<0.05),and it is the independent prognostic factors of patients with CCRCC,but Fuhrman classification,tumor size,lymph node metastasis,G6PD expression,VEGF expression and other factors were not statistically significant(P>0.05).Conclusions:1.The positive expression of G6PD and VEGF in CCRCC tissues is higher than para-carcinoma renal tissue.2.The positive expression of G6PD and VEGF in CCRCC tissues was positively correlated and promoted the development of CCRCC.3.The positive expression of G6PD and VEGF are both related to tumor size,lymph node metastasis and TNM staging of CCRCC,and it is expected to be one of the prognostic indicators.4.Although TNM staging is an independent prognosis influential factor of patients with CCRCC,the prognosis of CCRCC patients with G6PD and VEGF positive expression was worst. |
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