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目的探讨小儿肾母细胞瘤组织DNA水平对肿瘤临床生物学特性评估的价值。方法收集1993年1月-2007年12月临床病理证实为肾母细胞瘤患儿24例,依据美国国家肾母细胞瘤研究组(NWTSG)标准进行分期,其中Ⅰ期12例,Ⅱ期7例,Ⅲ期5例。并根据肿瘤细胞分化程度及有无淋巴结转移分组,肿瘤细胞高分化者10例,中分化者8例,低分化者6例。淋巴结转移者9例,未转移者15例。采用流式细胞仪测定其肿瘤组织DNA水平,采用χ2检验分析DNA倍体与肿瘤患者临床分期、细胞分化程度及淋巴结转移的关系。结果小儿肾母细胞瘤组织DNA异倍体主要存在临床分期Ⅱ、Ⅲ期(57.14%,100.0%),与Ⅰ期(25.0%)比较有显著性差异(P<0.05)。高分化组肿瘤细胞DNA异倍体率(20.0%)明显低于中、低分化组(75.0%,83.33%),高分化组与低分化组比较有显著性差异(P<0.05)。肿瘤组织DNA异倍体率在淋巴结转移组显著高于无淋巴结转移组(77.78%vs33.33%P<0.05)。结论小儿肾母细胞瘤组织中DNA水平检测对评价肾母细胞瘤生物学特性有重要意义。
Objective To investigate the value of DNA level in pediatric nephroblastoma to assess the clinical biological characteristics of tumor. Methods Twenty-four patients with pathologically confirmed nephroblastoma from January 1993 to December 2007 were enrolled in this study. They were staged according to the National Committee of Nephrology Study Group (NWTSG), including 12 cases of stage I and 7 cases of stage II , 5 cases of stage Ⅲ. According to the degree of tumor cell differentiation and the presence or absence of lymph node metastasis, 10 cases were highly differentiated tumor cells, 8 cases were moderately differentiated and 6 cases were poorly differentiated. 9 cases of lymph node metastasis, 15 cases of non-metastasis. The DNA level of tumor tissue was determined by flow cytometry. The relationship between DNA ploidy and clinical stage, cell differentiation and lymph node metastasis were analyzed by χ2 test. Results The DNA aneuploidy of pediatric nephroblastoma mainly existed in stage Ⅱ and Ⅲ (57.14%, 100.0%), which was significantly different from that in stage Ⅰ (25.0%) (P <0.05). The rate of DNA aneuploidy (20.0%) in well differentiated group was significantly lower than that in moderately and poorly differentiated group (75.0%, 83.33%). There was significant difference between well differentiated group and poorly differentiated group (P <0.05). The aneuploidy rate of tumor tissue in lymph node metastasis group was significantly higher than that in non-lymph node metastasis group (77.78% vs33.33% P <0.05). Conclusion The detection of DNA in pediatric nephroblastoma is of great significance in evaluating the biological characteristics of nephroblastoma.