局部肾细胞癌治疗前肾结构及细胞损害的标志物

E. Frantsiyants, N. Ushakova, D. A. Rozenko, N. Popova, A. D. Rozenko, A. Shulga
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摘要

研究目的:本研究的目的是分析局限性肾细胞癌(RCC)肾脏结构和细胞损害的分子标记参数,确定治疗前肾脏功能状态初始异常的性质。患者和方法。研究对象为国家肿瘤医学研究中心肿瘤内科接受选择性手术治疗的局限性肾癌患者46例。对照组包括13名健康人群的临床和实验室资料,这些健康人群在年龄和性别上与RCC患者相当。检测所有患者血、尿中胱抑素C、IL - 18、KIM - 1、L-FABP、NGAL含量。对RCC患者肾功能状态的评估显示,血清肌酐和肾小球滤过率的初始值与健康人的参考水平相似,但所有患者血液和尿液中胱抑素C浓度的比值与正常值相比有统计学意义。RCC患者L-FABP指数测定显示其水平是正常值的2.5倍,尿IL - 18浓度是正常值的1.7倍(p < 0.05)。血液和尿液中NGAL和KIM‑1的水平与对照组没有显著差异。局部肾细胞癌的发展伴随着肾滤过能力受损的小管间质功能障碍的形成。所有RCC患者均表现出内源性肾结构和细胞损伤标志物——胱抑素C、L-FABP和IL - 18升高。
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Markers of structural and cellular renal damage in localized renal cell carcinoma before treatment
Purpose of the study. The purpose of the study was to analyze parameters of molecular markers of structural and cellular renal damage in localized renal cell carcinoma (RCC) with determining the nature of the initial abnormalities in the kidney functional state before the treatment.Patients and methods. The study included 46 patients receiving elective surgical treatment for localized renal cancer in the Department of Oncourology, National Medical Research Centre for Oncology. The comparison group included the clinical and laboratory data of 13 healthy people comparable with the RCC patients in terms of age and gender. Cystatin C, IL‑18, KIM‑1, L-FABP, NGAL were determined in blood and urine in all patients.Results. Evaluation of the kidney functional state of RCC patients showed that the initial values of serum creatinine and the glomerular filtration rate were similar to the reference levels in healthy people, but statistically significant differences were found in the ratios of cystatin C concentrations in the blood and urine in all patients, compared with normal values. Determination of L-FABP indices in RCC patients showed that their levels were 2.5 times higher than normal values, and the urine concentration of IL‑18 was 1.7 times higher than normal values (p < 0.05). Blood and urine levels of NGAL and KIM‑1 did not differ significantly from the comparison group.Conclusions. The development of localized RCC is accompanied by the formation of tubulointerstitial dysfunction with impaired renal filtration capacity. All RCC patients showed elevated endogenous markers of structural and cellular renal damage – cystatin C, L-FABP, and IL‑18.
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