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Objective@#To determine the correlation of IgM deposition with clinic-pathological features and outcomes of IgA nephropathy patients.@*Methods@#A total of 1060 patients, who were diagnosed as IgA nephropathy by renal biopsies between 2001 and 2007 in Guangxing Hospital were enrolled. According to immunofluorescent test, patients were divided into patients with mesangial IgM deposition and patients without IgM deposition. Renal survival curves were assessed by Kaplan-Meier method. The effect of IgM deposition on outcomes of IgA nephropathy patients was examined by univariate and multivariable Cox proportional-hazards regression.@*Results@#Among 1060 IgA nephropathy patients, there were 750 patients with IgM deposition and 310 patients without IgM deposition. (1) Urinary protein and uric acid in patients with IgM deposition were significantly higher than those in patients without IgM deposition (all P<0.05). Other clinical indicators shown no statistical difference (all P>0.05). Moreover, IgM deposition patients had higher serum IgA, serum IgG and serum IgM (all P<0.05). (2) In pathological indicators, IgM deposition patients had more segmented sclerosis or adhesions (S1 of Oxford classification), activity lesions as inflammatory cell infiltration and mesangial proliferation, and chronic pathological changes as tubular atrophy, segmented glomerular damage than patients without IgM deposition (all P<0.05). (3) All patients were followed-up for a median of 89.7(61.8, 113.4) months, Kaplan-Meier analysis revealed that kidney survival rate was significantly lower in IgM deposition patients compared with patients without IgM deposition (Log-rank χ2=4.95, P=0.026). In a univariate Cox hazards regression mode, IgM deposition was a risk factor for poor prognosis of IgA nephropathy patients (HR=1.597, 95% CI 1.053-2.422, P=0.027). However, in a multivariable Cox analysis, IgM deposition shown no influence on outcomes of IgA nephropathy patients (HR=1.409, 95% CI 0.921-2.156, P=0.114).@*Conclusions@#IgA nephropathy patients with IgM deposition have higher urinary protein, and more serious pathological damage and immune fluorescence deposition. IgM deposition affects renal survival of IgA nephropathy, while IgM deposition is not an independent risk factor for prognosis of IgA nephropathy.
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Objective To explore the clinico-pathological features and outcomes of primary focal segmental glomerular sclerosis with IgM deposition.Methods One hundred and two patients with primary focal segmental glomemlar sclerosis (pFSGS) in Hangzhou hospital of traditional Chinese medicine between 1996 and 2012 were retrospectively studied.The patients were divided into IgM deposition group (n =66) with IgM deposition in glomeruli and none-IgM deposition group (n =36) without IgM deposition.Baseline and clinical characteristics of all FSGS patients were assessed and outcomes were reviewed.The survival rates of the patients were analyzed using the Kaplan-Meier method.Results (1) There were not difference in age,sex ratio,incidence of microscopic hematuria,hypertension,renal insufficiency,eGFR,Ccr and Scr between two groups.However,proteinuria,incidence of nephrotic syndrome,urine microalbumin,urine NAG,serum cholesterol,serum high-density lipoprotein,and serum IgM in IgM deposition group were significantly higher than those in none-IgM deposition group (P ＜ 0.05),serum albumin and serum IgA in IgM deposition group were significantly lower than those in none-IgM deposition group (P ＜ 0.05).(2) The IgM deposition group had a significantly higher incidence of glomerular deposition of IgA,IgG,C3,C1q and fibrinogen than none-IgM deposition group (P ＜ 0.05).The score of mesangial matrix proliferation in the IgM deposition group was lower than that in none-IgM deposition group (P ＜ 0.05).(3) fifty-four patients (35 patients in IgM deposition group and 19 patients in none-IgM deposition group) were followed-up for a median of 64.6 (22.8,103.8) months.Progression to renal failure was observed in 5 patients of IgM deposition group and none in none-IgM deposition group.Compared with the none-IgM deposition,the survival rates in the IgM deposition group were statistically lower (P ＜ 0.05).Conclusions PFSGS patients with IgM deposition were severer in proteinuria,higher incidence of IgA,IgG,C3,C1q and fibrinogen deposition in glomeruli and worse outcome than those without IgM deposition.
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Objective To study the expression of cyclin E and epidermal growth factor receptor (EGFR) in breast carcinoma and their correlation with metastasis,relapse and survival time. [WT5”HZ]Methods Cyclin E and EGFR expressions at protein level were determined by immunohistochemistry technique in 110 patients with breast carcinoma. Results Of the 110 patients,cyclin E and EGFR positive expression were both in 60 (54.55%),and there was a positive relationship between cyclin E and EGFR expression (r s=0.823,P =0.001);Cyclin E and EGFR expression level were correlated with clinical stage (? 2=12.86,P =0.005;? 2=14.21,P =0.004),tumor histological grading (? 2=8.86,P =0.005;? 2=4.90,P =0.04),lymph node metastasis (? 2=10.22,P =0.001;? 2=9.62,P =0.002),ER expression (? 2=29.8,P =0.001;? 2=32.08,P =0.001) and PR expression (? 2=19.56,P =0.001;? 2=26.92,P =0.001). The rate of local relapse and distant metastasis in cases with positive cyclin E and EGFR expression were significantly higher than that in cases with negative expression (? 2=7.33,P =0.01;? 2=7.88,P =0.005);The mean survival time and 5-year survival rate in cases with positive cyclin E and EGFR was significantly shorter than that in cases with negative expression. [WT5”HZ]ConclusionCyclin E and EGFR expression can predict the relapse and metastasis of breast carcinoma. They can be used as markers of prognosis of breast carcinoma in clinical practice.