成人IgA肾病中CD20的表达及意义
发布时间：2019-03-26 11:45
【摘要】：目的探讨CD20在不同肾功能状态的成人IgA肾病(IgA nephropathy,IgAN)患者肾组织中的表达及其与肾脏临床病理特征、预后的关系。方法将47例IgAN依据改良MDRD公式评估肾小球滤过率(estimated glomerular filtration rate,eGFR),将入选患者分为三组:A组(肾功能正常或轻度受损):eGFR60 ml/min;B组(肾功能中度受损):eGFR 30~60 ml/min;C组(肾功能重度受损,不含尿毒症):eGFR 10~30 ml/min。按Katafuchi评分标准进行肾活检病理评分,应用免疫组化法检测三组肾穿刺标本中CD20的表达,并对所有患者进行随访,复查相关临床指标。结果 CD20主要表达于IgAN患者肾组织皮质区肾小管管周间质B淋巴细胞胞膜。与eGFR60 ml/min组相比,eGFR 30~60 ml/min组、eGFR 10~30 ml/min组CD20表达量明显升高,差异有统计学意义(P值分别为0.002,0.001);肾组织中CD20表达量与eGFR呈负相关(r=-0.697,P0.001),与24 h尿蛋白定量、血清肌酐、肾小管间质积分呈正相关(r值分别为0.524、0.647、0.769;P均0.001)。结论肾组织中CD20的表达量与IgAN患者肾脏病理损伤指数、24 h尿蛋白定量、肾功能状态均密切相关,提示检测IgAN患者肾组织中CD20表达对了解肾脏病变程度、评估患者预后有一定临床价值。
[Abstract]:Objective to investigate the expression of CD20 in renal tissues of adult IgA nephropathy (IgA nephropathy,IgAN) patients with different renal function and its relationship with renal clinicopathological features and prognosis. Methods 47 patients with IgAN were divided into three groups: group A (normal or mild impairment of renal function): eGFR60 ml/min;. The glomerular filtration rate (estimated glomerular filtration rate,eGFR) was evaluated according to the modified MDRD formula. The patients were divided into three groups: group A (normal or mild impairment of renal function); Group B (moderate impairment of renal function): eGFR 30 / 60 ml/min;C group (severe impairment of renal function, excluding uremic): eGFR 10 / 30 ml/min. The pathological score of renal biopsy was evaluated according to Katafuchi scoring standard. The expression of CD20 in renal biopsy specimens of three groups was detected by immunohistochemical method. All the patients were followed up and the related clinical indexes were reexamined. Results CD20 was mainly expressed in the B cell membrane of renal tubulointerstitial B cells in the renal cortex of patients with IgAN. Compared with eGFR60 ml/min group, the expression of CD20 in eGFR 30 / 60 ml/min group and eGFR 10 / 30 ml/min group was significantly higher than that in eGFR group (P = 0.002, P < 0.001). The expression of CD20 in renal tissue was negatively correlated with eGFR (r = 0.697, P0.001), and positively correlated with 24 h urinary protein, serum creatinine and tubulointerstitial score (r = 0.524,0.647, 0.769, respectively, P 0.001). Conclusion the expression of CD20 in renal tissue is closely correlated with renal pathological injury index, 24-hour urinary protein quantity and renal function status in IgAN patients. It is suggested that detecting the expression of CD20 in renal tissue of IgAN patients is helpful to understand the degree of renal lesion. It is of clinical value to evaluate the prognosis of the patients.
【作者单位】： 北京大学深圳医院肾内科;江苏省镇江市第一人民医院肾内科;
【分类号】：R692.31
，
本文编号：2447511
[Abstract]:Objective to investigate the expression of CD20 in renal tissues of adult IgA nephropathy (IgA nephropathy,IgAN) patients with different renal function and its relationship with renal clinicopathological features and prognosis. Methods 47 patients with IgAN were divided into three groups: group A (normal or mild impairment of renal function): eGFR60 ml/min;. The glomerular filtration rate (estimated glomerular filtration rate,eGFR) was evaluated according to the modified MDRD formula. The patients were divided into three groups: group A (normal or mild impairment of renal function); Group B (moderate impairment of renal function): eGFR 30 / 60 ml/min;C group (severe impairment of renal function, excluding uremic): eGFR 10 / 30 ml/min. The pathological score of renal biopsy was evaluated according to Katafuchi scoring standard. The expression of CD20 in renal biopsy specimens of three groups was detected by immunohistochemical method. All the patients were followed up and the related clinical indexes were reexamined. Results CD20 was mainly expressed in the B cell membrane of renal tubulointerstitial B cells in the renal cortex of patients with IgAN. Compared with eGFR60 ml/min group, the expression of CD20 in eGFR 30 / 60 ml/min group and eGFR 10 / 30 ml/min group was significantly higher than that in eGFR group (P = 0.002, P < 0.001). The expression of CD20 in renal tissue was negatively correlated with eGFR (r = 0.697, P0.001), and positively correlated with 24 h urinary protein, serum creatinine and tubulointerstitial score (r = 0.524,0.647, 0.769, respectively, P 0.001). Conclusion the expression of CD20 in renal tissue is closely correlated with renal pathological injury index, 24-hour urinary protein quantity and renal function status in IgAN patients. It is suggested that detecting the expression of CD20 in renal tissue of IgAN patients is helpful to understand the degree of renal lesion. It is of clinical value to evaluate the prognosis of the patients.
【作者单位】： 北京大学深圳医院肾内科;江苏省镇江市第一人民医院肾内科;
【分类号】：R692.31
，
本文编号：2447511
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