临床免疫学—讨论课1-文献阅读与评价.ppt

Evaluation of Urine Aquaporin 1 and Perilipin 2 Concentrations as Biomarkers to Screen for Renal Cell Carcinoma 文献阅读与评价 Importance of research 1. Early detection of small asymptomatic kidney tumors presages better patient outcome. 2. Incidental discovery of asymptomatic renal tumors by abdominal imaging is expensive and cannot reliably distinguish benign from malignant tumors. Purpose of research To evaluate the clinical utility, sensitivity and specificity of urine aquaporin-1 (AQP1) and perilipin-2 (PLIN2) concentrations as unique noninvasive biomarkers to diagnose malignant clear cell or papillary renal cell carcinoma (RCC) in a screening paradigm. Why to focus on AQP1 and PLIN2 Our previous studies have shown that AQP1 and PLIN2 concentrations were significantly higher in patients with clear cell and papillary cancers compared with controls, were correlated with tumor size, and stage (but not grade), and were decreased over 83% following tumor excision. Urine concentrations of AQP1 or PLIN2 were not increased in patients with a) common non-cancerous kidney diseases such as diabetic nephropathy, glomerulonephritis and urinary tract infections, b) non-cancerous kidney tumors (oncocytomas, angiomyolipomas), or c) bladder or prostate cancer. These studies are consistent with the first two phases of diagnostic cancer biomarker development by identifying promising biomarkers (phase 1) and establishing that the biomarkers identify clinical disease from potential confounding diseases (phase 2). How to do Urine samples were obtained from 720 patients undergoing routine abdominal CT (screening population, including 334 no history of cancer and 386 with history of cancer), 80 healthy controls and 19 patients with pathologically confirmed RCC. Urine AQP1 and PLIN2 concentrations were measured by sensitive and specific ELISA and Western blot procedures, respectively. Clinical and pathological data Results Figure 1. Dot and box representation of urine