ABSTRACT
Purpose To observe the clinical characteristics, expression of C4d and the morphology of podocyte lesions in steroid-sensitive minimal change disease (SS-MCD) ,steroidresistant minimal change disease (SR-MCD) and early focal segmental glomerulosclerosis (E-FSGS) ,as well as to analyze their differences among the three groups,and provide a novel method for effective evaluation the therapeutic effects of steroid and diagnosis of SR-MCD. Methods To study the clinical data from 24 cases of SS-MCD,30 cases of SR-MCD and 25 cases of E-FSGS as control,and all the biopsies were examined by light microscopy,immunohistochemistry and transmission electron microscopy. Meanwhile,the clinical characteristics,the morphology of podocyte lesion and the expression of C4d were observed. Results The average score of podocyte lesion of SR-MCD was higher than that of SS-MCD,but lower than that of E-FSGS (P< 0. 05) . C4d positive average score of SS-MCD was lower than that of both SR-MCD and E-FSGS (P < 0. 05) ,but there was no significant difference between SR-MCD and E-FSGS (P > 0. 05) . The sum of the average score of podocyte lesion and C4d positive average score of SS-MCD was lower than that of SRMCD and E-FSGS (P < 0. 01) ,however,there was also no significant difference between SR-MCD and E-FSGS(P > 0. 05) . The scores of IgM,C3d and C1q were not significantly different among the three groups. The area under the receiver operating curve (ROC) of the C4d positive score,podocyte lesion score and the sum of the two were 0. 753,0. 658 and 0. 803,respectively, and there was no significant difference between them and the optimal cutoff values were 3,1. 5,and 4. 5 points,respectively. Conclusions The C4d positive score,podocyte lesion score and the sum of the two scores of MCD (the last one is named for MCD nephropathy score in our study) can be used for evaluating the therapeutic effects of steroid and identification of SR-MCD,most especially MCD nephropathy score. The optimal cut-off values of the three kinds of scores are 3,1. 5,and 4. 5 points,respectively. When the values are exceeded,the clinicians should be reminded to follow-up and take appropriate treatment measures to patients.
ABSTRACT
Purpose To investigate the expression of insulin-like growth factor Ⅱ mRNA-binding protein 3 (IMP3) and its differential diagnostic significance in benign and malignant thyroid tumor. Methods The fluorescent quantitative PCR and immunohistochemical staining were used to detect the IMP3 expression in 71 cases of thyroid tissue of different pathological types. The differential diagnostic significance of IMP3 expression in benign and malignant thyroid tumor was analyzed. Results Compared with normal thyroid tissue, thyroid tumors including follicular variant of papillary thyroid carcinoma (FVPTC ), follicular thyroid carcinoma (FTC), papillary thyroid carcinoma(PTC), nodular goiter (NG), and follicular adenoma (FA) had significantly higher IMP3 mRNA expression levels with10.13, 8.81, 8.52, 2.46, and 1.49 holds, respectively. The positive expression rate of IMP3 protein in thyroid tumors were significantly higher, with the positive rate from high to low was FTC (100％ ), PTC (96.77％ ), FVPTC (90％ ), FA(20％ ), and NG (0). The expression level of IMP3 protein was positively correlated with the expression of mRNA (P＜0.01). The IMP3 expression level of malignant thyroid tumor(8.82 holds) was significantly higher than that of benign thyroid tumor (1.94 holds) (P＜0.01). The IMP3 expression level of malignant thyroid follicular lesions (9.36 holds) was higher than that of benign thyroid follicular lesions (1.49 holds) (P＜0.01). Conclusion IMP3 may be an effective and useful molecular maker for diagnosis of benign and malignant thyroid neoplasms, as well as the differential diagnosis between benign and malignant thyroid follicular lesions.