[Expression and clinical significance of kidney injury molecule-1 in renal epithelial neoplasms].
OBJECTIVE
To study the expression and clinical significance of kidney injury molecule-1 (KIM-1) in primary and metastatic renal epithelial neoplasms.


METHODS
A total of 136 cases of kidney neoplasms were retrospectively reviewed including 63 primary clear cell renal cell carcinomas (RCCs), 22 papillary RCCs, 13 chromophobe RCCs, 7 oncocytomas, 7 RCCs associated with Xp11.2 translocation/TFE3 gene fusions and 24 metastatic clear cell RCCs. Immunostaining for KIM-1 and kidney-specific-protein (Ksp)-cadherin were performed and the relationship to tumor stage and grade in clear cell RCCs was investigated.


RESULTS
Expression of KIM-1 was detected in 77.8% (49/63) of clear cell RCCs, 90.9% (20/22) of papillary RCCs, 1/13 of chromophobe RCCs, 7/7 of RCCs associated with Xp11.2 translocation/TFE3 gene fusions and 87.5%(21/24) of the metastatic RCCs, but not detected in 7 cases of oncocytomas. A diffuse expression of KIM-1 was more frequently observed in Furhman nuclear grade III/IV clear cell RCCs (P = 0.010). Ksp-cadherin expression was mainly observed in chromophobe RCCs and oncocytomas.


CONCLUSIONS
KIM-1 is a specific biomarker for injuried kidney proximal tubules and the corresponding neoplasms, and has a high specificity and sensitivity for primary or metastatic clear cell RCCs, papillary RCCs and RCCs associated with Xp11.2 translocation/TFE3 gene fusions. Combination of KIM-1 and Ksp-cadherin immunostaining can lead to a more precise histological classification of primary kidney epithelial neoplasms and improve the diagnostic accuracy of metastatic RCCs.
Dong
Ying-chun
YC
Department of Pathology, Clinical School of Medical College of Nanjing University/Nanjing General Hospital of Nanjing Military Command, People's Liberation Army, China.
Wu
Bo
B
Wang
Jian-dong
JD
Rao
Qiu
Q
Ma
Heng-hui
HH
Zhang
Ru-song
RS
Zhou
Hang-bo
HB
Lu
Zhen-feng
ZF
Zhou
Xiao-jun
XJ
D018249:Adenoma, Oxyphilic / Q000378:metabolism / Q000473:pathology; D051778:Basic Helix-Loop-Helix Leucine Zipper Transcription Factors / Q000235:genetics / Q000378:metabolism; D001859:Bone Neoplasms / Q000378:metabolism / Q000556:secondary; D015820:Cadherins / Q000378:metabolism*; D002291:Carcinoma, Papillary / Q000378:metabolism / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D041321:Chromosomes, Human, X; D050939:Gene Fusion; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007680:Kidney Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D008175:Lung Neoplasms / Q000378:metabolism / Q000556:secondary; D008562:Membrane Glycoproteins / Q000378:metabolism*; D009375:Neoplasms, Glandular and Epithelial / Q000145:classification / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D011991:Receptors, Virus / Q000378:metabolism*; D012189:Retrospective Studies; D014178:Translocation, Genetic
D051778:Basic Helix-Loop-Helix Leucine Zipper Transcription Factors; C114483:CDH16 protein, human; D015820:Cadherins; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D008562:Membrane Glycoproteins; D011991:Receptors, Virus; C069203:TFE3 protein, human