肾脏肿瘤诊断和预后相关的生物学标记

本文译者hezejihongRenaltumors:diagnosticandprognosticbiomarkers.肾脏肿瘤：诊断和预后相关的生物学标记Abstract

TheInternationalSocietyofUrologicalPathologyconvenedaconsensusconferenceonrenalcancer,precededbyanonlinesurvey,toaddressissuesrelatingtothediagnosisandreportingofrenalneoplasia.Inthisreport,theroleofbiomarkersinthediagnosisandassessmentofprognosisofrenaltumorsisaddressed.Inparticularwefocusedupontheuseofimmunohistochemicalmarkersandtheapproachtospecificdifferentialdiagnosticscenarios.Weenquiredwhethercytogeneticandmoleculartoolswereappliedinpracticeandaskedforviewsontheperceivedprognosticroleofbiomarkers.Boththesurveyandconferencevotingresultsdemonstratedahighdegreeofconsensusinparticipantsresponsesregardingprognostic/predictivemarkersandmoleculartechniques,whereasitwasapparentthatbiomarkersforthesepurposesremainedoutsidethediagnosticrealmpendingclinicalvalidation.Althoughnoindividualantibodyorpanelofantibodiesreachedconsensusforclassifyingrenaltumors,orforconfirmingrenalmetastaticdisease,itwasnotedfromtheonlinesurveythat87%ofrespondentsusedimmunohistochemistrytosubtyperenaltumorssometimesoroccasionally,andamajority(87%)usedimmunohistochemicalmarkers(PaxorPax8,renalcellcarcinoma[RCC]marker,panelofpan-CK,CK7,vimentin,andCD0)inconfirmingthediagnosisofmetastaticRCC.TherewasconsensusthatimmunohistochemistryshouldbeusedforhistologicsubtypingandappliedbeforereachingadiagnosisofunclassifiedRCC.Attheconference,therewasconsensusthatTFE3andTFEBanalysisoughttoberequestedwhenRCCwasdiagnosedinayoungpatientorwhenhistologicappearancesweresuggestiveofthetranslocationsubtype;whereasPaxand/orPax8wereconsideredtobethemostusefulmarkersinthediagnosisofarenalprimary.

摘要

　　国际泌尿病理学会经在线调查，就肾脏肿瘤问题达成了共识，强调了肾脏肿瘤相关的诊断和报告问题。在这篇报道中，主要强调了肾脏肿瘤诊断及预后评估相关的生物分子。尤其着眼于免疫组化标记的应用及其在鉴别诊断中的应用。我们调查了细胞遗传学及分子检测是否用于了常规工作中，并征求了生物学标记实际预后意义的意见。该调查及投票得出的共识结果表明，参与者对预后/预测的生物学标记及分子技术具有高度共识，但很明显的是该目的的生物标记尚未经临床研究验证，仍处于诊断领域之外。尽管尚未有单个或一组抗体能完全区分肾脏肿瘤、或确诊肾脏转移性疾病，但也注意到，在线调查中87%的参与者有时或者偶尔用免疫组化的方法来进行肾脏肿瘤的分类，大多数（87%）的参与者使用免疫组化标记（Pax或者Pax8，肾细胞癌标记，一组广谱CK，CK7，vimentin和CD0）来确定转移性肾细胞癌的诊断。大家一致认为免疫组化应当用于形态学分类中，尤其是在诊断无法分类的肾细胞癌时。此次会议一致认为在年轻患者诊断为肾细胞癌或者形态学提示可能是有易位的亚型时应当进行TFE3和TFEV分析，Pax和/或Pax8被认为是诊断肾脏原发肿瘤中最有用的标记。

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