Diagnostic value of cytokeratin 7 and parvalbumin in differentiating chromophobe renal cell carcinoma from renal oncocytoma.
Diagnostic value of cytokeratin 7 and parvalbumin in differentiating chromophobe renal cell carcinoma from renal oncocytoma.
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发表时间：
2006-08
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通讯作者：
B. Adley;V. Papavero;J. Sugimura;B. Teh;Ximing J. Yang
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作者：
B. Adley;V. Papavero;J. Sugimura;B. Teh;Ximing J. Yang
目的探讨细胞角蛋白7（CK 7）和小清蛋白在mRNA和蛋白水平上的诊断价值。研究设计采用基因表达微阵列技术检测23例嗜酸细胞瘤和32例嫌色细胞肾细胞癌（RCC）中CK 7和小清蛋白mRNA的表达水平。免疫组化采用CK 7或小清蛋白特异性单克隆抗体在41嫌色细胞RCC和55嗜酸细胞瘤。结果32例嫌色细胞癌中有18例CK 7 mRNA过表达，而23例嗜酸细胞瘤中仅3例CK 7 mRNA过表达。32例嫌色细胞癌中有15例小白蛋白mRNA过表达，23例嗜酸细胞瘤中只有4例小白蛋白mRNA过表达。相比之下，CK 7 mRNA在23例嗜酸细胞瘤中有13例低表达，在32例嫌色细胞癌中只有6例低表达，而小白蛋白在23例嗜酸细胞瘤中有14例低表达，在32例嫌色细胞癌中只有6例低表达。通过免疫组化，27 41（66%）嫌色RCC表达CK 7弥漫相比，只有3 55（5%）嗜酸细胞瘤。弥漫性小白蛋白表达见于所有41/41（100%）嫌色细胞RCC，仅见于26/55（47%）嗜酸细胞瘤。结论肾嫌色细胞癌中CK 7的mRNA和蛋白表达水平均显著高于嗜酸细胞瘤（p < 0.001）。嗜酸细胞瘤中小清蛋白表达的特异性较低，但常呈斑片状。我们的研究提供了进一步的证据，CK 7和小清蛋白免疫染色可能有助于区分嗜酸细胞瘤和嫌色细胞肾细胞癌的疑难病例。CK 7和/或小白蛋白阴性或斑片状染色（< 50%细胞）强烈支持嗜酸细胞瘤的诊断。
OBJECTIVE To investigate the diagnostic value of cytokeratin 7 (CK7) and parvalbumin at mRNA and protein levels. STUDY DESIGN CK7 and parvalbumin mRNA expression levels in 23 oncocytomas and 32 chromophobe renal cell carcinomas (RCCs) were examined using gene expression microarrays. Immunohistochemistry was performed using monoclonal antibodies specific for CK7 or parvalbumin in 41 chromophobe RCCs and 55 oncocytomas. RESULTS CK7 mRNA was overexpressed in 18 of 32 chromophobe RCCs but only 3 of 23 oncocytomas. Parvalbumin mRNA was overexpressed in 15 of 32 chromophobe RCCs and only 4 of 23 oncocytomas. In contrast, CK7 mRNA underexpression was noted in 13 of 23 oncocytomas and only 6 of 32 chromophobe RCCs, while parvalbumin underexpression was seen in 14 of 23 oncocytomas but only 6 of 32 chromophobe RCCs. By immunohistochemistry, 27 of 41 (66%) chromophobe RCCs expressed CK7 diffusely compared to only 3 of 55 (5%) oncocytomas. Diffuse parvalbumin expression was seen in all 41 of 41 (100%) chromophobe RCCs and only in 26 of 55 (47%) oncocytomas. CONCLUSION Both mRNA and protein expression levels of CK7 appear significantly higher in chromophobe RCC compared to oncocytoma (p < 0.001). Parvalbumin expression is less specific but often displays a patchy pattern in oncocytomas. Our study provides further evidence that CK7 and parvalbumin immunostains may be useful in differentiating oncocytoma from chromophobe RCC in problematic cases. Negative or patchy staining (< 50% cells) for CK7 and/or parvalbumin strongly favors the diagnosis of oncocytoma.