■微小病变性肾病综合征(MCNS)和局灶性节段性肾小球硬化(FSGS)是儿童和成人肾病综合征(NS)的两个常见原因,具有重叠的临床特征。但具有不同的预后和治疗意义。这些之间的区别完全取决于组织病理学,有时很难。CD44由活化的壁上皮细胞表达,在基质沉积中起作用,从而在FSGS的发病机理中起作用。
■评估CD44在MCNS和FSGS中的表达,并评估其与已知临床和组织病理学预后因素的关系。
■研究了30例MCNS和FSGS。临床,实验室,组织病理学,并记录CD44免疫组织化学数据。对调查结果进行了分析和关联。P值<0.05被认为具有统计学意义。
■CD44阳性与血清肌酐之间存在统计学关联(p=0.031),估计肾小球滤过率(p=0.040),节段性硬化症(p<0.001),肾小管萎缩(p=0.027),间质纤维化(p=0.027),和组织学诊断(p<0.001)。敏感性,特异性,阳性预测,阴性预测值为90%,76.67%,79.41%和88.46%,分别。
■CD44免疫染色可有效区分MCNS和FSGS。CD44阳性与已知预后因素的一致结果支持使用CD44标记作为选择高风险患者并提供适当治疗措施的预测工具的可能性。
UNASSIGNED: Minimal change nephrotic syndrome (MCNS) and focal segmental glomerulosclerosis (FSGS) are the two common causes of nephrotic syndrome (NS) in both children and adults with overlapping clinical features, but with distinct prognostic and therapeutic implications. The distinction between these relies entirely on histopathology, which can sometimes be difficult. CD44 is expressed by activated parietal epithelial cells, plays a role in matrix deposition and thus in the pathogenesis of FSGS.
UNASSIGNED: To assess the expression of CD44 in MCNS and FSGS and to evaluate its association with the known clinical and histopathological prognostic factors.
UNASSIGNED: Thirty cases each of MCNS and FSGS were studied. The clinical, laboratory, histopathological, and CD 44 immunohistochemical data were recorded. The findings were analyzed and correlated. A P value of < 0.05 was considered statistically significant.
UNASSIGNED: Statistical association was noted between CD44 positivity and serum creatinine (p = 0.031), estimated glomerular filtration rate (p = 0.040), segmental sclerosis (p < 0.001), tubular atrophy (p = 0.027), interstitial fibrosis (p = 0.027), and histological diagnosis (p < 0.001). The sensitivity, specificity, positive predictive, and negative predictive values were 90%, 76.67%, 79.41% and 88.46%, respectively.
UNASSIGNED: CD44 immunostain can effectively distinguish MCNS from FSGS. The congruent results of CD44 positivity with known prognostic factors support the possibility of using the CD44 marker as a predictive tool in selecting high-risk patients and offering appropriate therapeutic measures.