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目的细胞间黏附分子-1(intercellular cell adhesion molecule-1,ICAM1)在多种恶性肿瘤中都发挥着重要作用,但其对肾透明细胞癌(clear-cell renal cell carcinoma,ccRCC)的影响鲜见报道。本研究旨在探讨ICAM1在ccRCC预后判断以及早期诊断中的意义。方法随机选择2000-01-18-2010-09-08皖南医学院弋矶山医院ccRCC手术冷冻标本173例,利用免疫组织化学(immunohistochemistry,IHC)方法检测ICAM1在ccRCC中的表达,并分析ICAM1表达与临床病理参数的相关性。应用生存分析研究ICAM1表达对ccRCC患者肿瘤特异生存率(cancer-specific survival,CSS)的影响。通过计算受试者工作特征曲线(receiver operating charccteristic curve,ROC)下的面积(area under the ROC curve,AUC)来评价ICAM1表达对ccRCC早期诊断的价值。结果173例ccRCC标本组织中,ICAM1阳性率为83.2%(144/173);173例对应的癌旁正常肾小管上皮组织中,ICAM1均为阴性。ICAM1在男性(χ~2=9.208,P=0.002)、T3/T4期(χ~2=5.207,P=0.022)、非N0M0期(χ~2=4.306,P=0.038)以及肾盂侵犯(χ~2=4.124,P=0.042)等亚组中高表达率分别为56.9%(74/130)、65.9%(27/41)、75.0%(12/16)和67.9%(19/28),均高于对照组,差异有统计学意义。Kaplan-Meier生存分析提示,ICAM1高表达时,ccRCC患者的CSS显著下降(P<0.001),5和10年累积CSS与ICAM1低表达患者相比,分别下降了21.6%和14.1%。Cox回归分析提示,ICAM1是判断ccRCC患者CSS的独立预测因子,P=0.005。ICAM1在ccRCC早期诊断中的AUC值为0.916,P<0.001。结论 ICAM1高表达时,ccRCC患者预后差,ICAM1是判断ccRCC患者预后的独立预测因子,并且可能成为ccRCC早期诊断的潜在标志物。
Objective Intercellular cell adhesion molecule-1 (ICAM1) plays an important role in many malignant tumors, but its effect on clear-cell renal cell carcinoma (ccRCC) is rare Reported. This study aimed to investigate the significance of ICAM1 in the prognosis and early diagnosis of ccRCC. Methods Totally 173 cases of ccRCC from Yijishan Hospital of Wannan Medical College were recruited from January 2000 to June 18,2010. The expression of ICAM1 in ccRCC was detected by immunohistochemistry (IHC) Correlation with clinicopathological parameters. The effect of ICAM1 expression on the cancer-specific survival (CSS) in patients with ccRCC was studied using survival analysis. The value of ICAM1 expression in the early diagnosis of ccRCC was evaluated by calculating the area under the receiver operating characteristic (ROC) curve (AUC). Results The positive rate of ICAM1 in 173 cases of ccRCC specimens was 83.2% (144/173). The ICAM1 was negative in 173 corresponding normal renal tubular epithelial tissues. ICAM1 was significantly higher in male (χ ~ 2 = 9.208, P = 0.002), T3 / T4 (χ ~ 2 = 5.207, P = 0.022), non-N0M0 (χ ~ 2 = 4.306, P = 0.038) ~ 2 = 4.124, P = 0.042). The high expression rates in subgroups were 56.9% (74/130), 65.9% (27/41), 75.0% (12/16) and 67.9% (19/28) Higher than the control group, the difference was statistically significant. Kaplan-Meier survival analysis showed that CSS was significantly decreased in patients with ccRCC when ICAM1 was highly expressed (P <0.001), and decreased by 21.6% and 14.1% at 5 and 10 years of cumulative CSS compared with patients with low expression of ICAM1. Cox regression analysis suggested that ICAM1 was an independent predictor of CSS in patients with ccRCC, P = 0.005. The AUC value of ICAM1 in the early diagnosis of ccRCC was 0.916, P <0.001. Conclusion The high expression of ICAM1 has a poor prognosis in patients with ccRCC. ICAM1 is an independent predictor of prognosis in patients with ccRCC and may be a potential biomarker for early diagnosis of ccRCC.