PURPOSE To explore the regulatory roles of microRNA-140 and SOX4 in prostate cancer (PCa) tissues and paracancerous tissues, and their underlying mechanism. METHODS MicroRNA-140 expressions in PCa tissues, paracancerous tissues and PCa cell lines were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Proliferation, apoptosis and cell cycle of PCa cells after altering expressions of microRNA-140 and SOX4 were detected by MTT assay and flow cytometry, respectively. The regulatory effect of microRNA-140 on SOX4 was detected by Western blot and qRT-PCR. The binding condition of microRNA-140 on SOX4 was verified by luciferase reporter gene assay. RESULTS MicroRNA-140 was downregulated in PCa tissues compared to paracancerous tissues. In particular, lower expression of microRNA-140 was found in PCa with Grade I+II compared to Grade III+IV. In vitro, microRNA-140 expression was negatively correlated with proliferative and invasive abilities, while positively correlated with apoptosis of PCa cells. MicroRNA-140 promoted cell cycle arrest in G0/G1 phase. SOX4 expression was inhibited by microRNA-140 overexpression in PCa cells. CONCLUSIONS Downregulated microRNA-140 promotes proliferation and cell cycle arrest, but inhibits apoptosis of PCa cells. MicroRNA-140 inhibits PCa development via degrading SOX4.

BACKGROUND/AIM:Epigenetic inactivation of tumor suppressor genes is an important molecular mechanism in the formation and development of human tumors. The purpose of our study was to evaluate the correlation between the methylation level of the secreted frizzled-related protein 1 (SFRP1) gene and the risk of renal cell carcinoma (RCC). METHODS:The relevant literature was searched in detail in several electronic databases. The methodological heterogeneity was analyzed by meta-regression and subgroup analyses. The odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated to summarize the dichotomous outcomes of our meta-analysis. RESULTS:The ten included articles contained 535 RCC samples and 475 normal controls. The results demonstrated that the methylation level of the SFRP1 promoter region was significantly correlated with an increased incidence of RCC (OR=13.72; 95% CI: 6.01-31.28; P=0.000). Furthermore, the eligible studies that had sufficient clinical data about the RCC cases were included in the analysis, and the results indicated that the frequency of SFRP1 promoter methylation was associated with a higher histological grade (P=0.000), tumor stage (P=0.033), tumor size (≥5 cm; P=0.029), and distant metastasis (P=0.047). CONCLUSION:Our results indicate that the methylation level of the SFRP1 promoter region is increased in patients with RCC compared to normal controls and might be involved in the occurrence and development of RCC. Additional well-designed studies are needed to further verify our conclusions.

Objective To systemically evaluate the efficacy of vacuum erectile device in the treatment of erectile dysfunction after radical prostatectomy.Methods Such Databases as Pubmed,Cochrane library,CNKI,VIP,and Wanfang were searched systematically for clinical-controlled studies that investigated the efficacy of vacuum erectile device in the treatment of erectile dysfunction after radical prostatectomy.The last search updated on 15 June 2017.Literature screening and data extractions were performed by two researchers respectively.Meta analysis of the value of the outcome index was performed by using Stata12.0 software.Results A total of 5 studies were eligible for the Meta-analysis.The results of Meta analysis showed that IIEF-5 score of vacuum erectile device in the treatment of erectile dysfunction after radical prostatectomy was significantly higher than that in the control group,with statistically significant difference (OR=4.87,95％CI:3.65-6.09,P＜0.001).Conclusion Vacuum erectile device is safe and effective in the treatment of erectile dysfunction after radical prostatectomy.

Objective To explore the clinical value of kidney tumor measurement scoring system (R.E.N.A.L.) for partial nephrectomy and to analyze the influencing factors of partial nephrectomy.Methods The clinical data of 83 cases of partial nephrectomy from January 2009 to June 2016 were reviewed.According to the R.E.N.A.L.scoreing system, the patients were divided into three groups including low risk group, median risk group and high risk group.The operating time, peri-operative bleeding, warm ischemic time, postoperative hospital stay, serum creatinine change as well as postoperative complications among these groups were compared.The correlation between postoperative complications and R.E.N.A.L.scoreing system was analyzed.Logistic regression analysis was applied to define possible predictors of the partial nephrectomy.Results There were 29 cases in low risk group, 43 cases in median risk group, and 11 cases in high risk group.The preoperative hypoproteinemia occurrence was lower, operating time and hospital stays were shorter, and tumor size was less among patients of low score of R.E.N.A.L.than high score of R.E.N.A.L.(F/χ2=17.300, 28.980, 7.160, 12.860,P=0.000, 0.000, 0.001, 0.073).With increases in R.E.N.A.L.scores, the incidence of Clavien complications in postoperative patients was on the rise (P=0.788, 0.081, 0.368, 0.133).Logistic regression analysis showed that preoperative hypoproteinemia, operative time, tumor size and hospital stays were the influencing factors for surgical effects in patients with partial nephrectomy.Conclusion R.E.N.A.L.scoreing system is a validated method that can be successfully used to evaluate operation difficulty during R.E.N.A.L.tumor.Preoperative application of R.E.N.A.L.scoreing system to identify tumor complexity will contribute to guide the operator selecting the suitable operations for partial nephrectomy.The main influencing factors of surgical effects for partial nephrectomy include preoperative hypoproteinemia, operative time, tumor size, hospital stays, etc.

Background Placenta specific 8 (PLAC8) plays an important role in many different cellular processes and human diseases, including multiple types of cancer. However, the functional role of PLAC8 in clear cell renal cell carcinoma (ccRCC) has never been elucidated. Methods PLAC8 mRNA expression was investigated in 31 pairs of fresh ccRCC tumor tissues and matched adjacent non-tumor tissues by RT-qPCR and confirmed by analyzing the TCGA KRCC dataset which contains RNA-seq data of 534 ccRCC and 72 solid normal tissues. Protein level of PLAC8 expression was also investigated using immunohistochemistry in 129 ccRCC samples. Correlations with clinicopathological factors and overall survival were analyzed. To examine its effect on the biological activity, PLAC8 siRNAs were transfected into ccRCC cells. Cell proliferation was assessed by CCK8 cell viability assays, clone formation assays, and EdU incorporation assays. Cell invasion was examined using transwell assays. RNA sequencing was then performed to further elucidate the mechanisms by which PLAC8 regulates the cancer. Results PLAC8 expression was positively correlated with tumor size, metastasis, and clinical stage of ccRCC. Additionally, high PLAC8 expression was closely associated with a shorter overall survival time. Knockdown of PLAC8 with siRNAs significantly reduced the proliferation and invasion of RCC cells and increased the sensitivity of RCC cells to cisplatin. RNA-seq analysis revealed that knockdown of PLAC8 down-regulated the expression of a panel of inflammatory mediators, which suggested that PLAC8 is associated with the ccRCC inflammatory microenvironment. Patients with high expression of PLAC8 had a significantly higher number of infiltrative lymphocytes than patients with low expression of PLAC8. Conclusion Our findings suggest that PLAC8 may be a potential prognostic indicator and therapeutic target for ccRCC.

Background/aim: The purpose of our study is to assess the association between the methylation level of tissue inhibitor of metalloproteinase-3 (TIMP3) and risk of renal cell carcinoma (RCC). Methods: A systematic review of relevant literature from PubMed, EMBASE, Web of Science, and the Cochrane Library databases was conducted. Odds ratio (OR) and its corresponding 95% confidence interval (CI) were calculated to analyze the data and acquire comprehensive results. Results: Ten eligible kinds of literature including 495 RCC specimens and 409 normal controls were analyzed in this meta-analysis. The results indicated that TIMP3 promoter hypermethylation was correlated with RCC-increased risk (OR=12.16, 95% CI: 3.64-40.66, P<0.001). The results of subgroup analysis revealed that the OR of the urine subgroup (OR=22.16) was greater than that of the tissue (OR=13.15) and blood subgroups (OR=3.20). Furthermore, the results of five studies containing RCC clinicopathological features indicated that the methylation level of TIMP3 gene was related to low tumor stage (OR=2.77, 95% CI: 1.48-5.18, P=0.001). Conclusion: Our results suggested that the methylation level of TIMP3 promoter region was significant in RCC. Moreover, the finding is related to early tumor stage. The detection of TIMP3 promoter methylation may be a good strategy for the diagnosis of RCC at its early stages. Nevertheless, additional well-designed studies are needed to further prove our conclusion. Correspondence to: Caiyong Lai, Department of Urology, The First Affiliated Hospital of Jinan University, No.613 west huangpu avenue, Guangzhou 510630, Guangdong, China, Tel: 0086 20 38688303; E-mail: 294037978@qq.com

Objective To study methylation level,protein and mRNA expressions of PEG10 in villi tissues and spousal sperms in patients with unexplained recurrent spontaneous abortion (URSA).Methods From January 2014 to October 2016,100 patients with URSA treated in Reproductive Medicine Center of the hospital were collected as G2 group,100 cases of their spouses were selected as G4 group,100 cases of voluntary abortion in early pregnancy were selected as G1 group,and 100 cases of their spouses were selected as G3 group.The protein levels of PEG10 imprinted gene were detected by immunohistochemistry and Western blot,and the levels of PEG10 mRNA were detected by RT-PCR.After exact matching three URSA patients and their spouses,three voluntary abortion patients in early pregnancy and their spouses,6 villi samples and 6 sperm samples were obtained for methylation microarray detection of PEG10 methylation level.Results There was statistically significant difference in mean methylation level in DMR zone of PEG10 gene in villi tissues between URSA group and voluntary abortion group (P＜0.05).There was no statistically significance difference in mean methylation level in DMR zone of PEG10 gene in spousal sperms between URSA group and voluntary abortion group (P＞0.05).The results of immunohistochemical assay showed that the expression level of PEG10 in villi in URSA group was weaker than that in voluntary abortion group.The results of Western blot showed that the expression level of PEG10 protein in villi in URSA group was statistically significantly lower than that in voluntary abortion group (P＜0.001).The results of RT-PCR showed that the expression level of PEG10 mRNA in villi in URSA group was statistically significantly lower than that in voluntary abortion group (P＜0.001).Conclusion Paternal imprinted gene PEG10 has a certain correlation with early embryonic development,whose low expression may be one of the possible reasons for URSA.The situation of early embryonic development cannot be inferred by detecting methylation level of PEG10 in sperms.

Objective To explore the Clavien complications of patients given radical cystectomy and double cutaneous ureterostomy and to analyze the influencing factors.Methods The clinical data of 117 cases undergoing radical cystectomy and double cutaneous ureterostomy from January 2002 to June 2015 were reviewed.The Clavien classification system was carried out to stratify perioperative complications.Logistic regression analysis was applied to define possible predictors of the perioperative complications.Results Of the 117 subjects at least 1 perioperative complication developed in 51, including 3 cases of intraoperative complications.According to the Clavien system, 30 patients had grade 1-2, and 21 patients had grade 3-4 complications.The most frequent complication was incision-related complications, followeb by the gastrointestinal complications and lung infections.The total incidence of perioperative complications was lower in the laparoscope group than in the open surgery group (28.57% vs.48.31%, χ2=0.171, P=0.680), and the incidence of perioperative complications of Clavien 1-2 was lower in the laparoscope group than in the open surgery group with the difference being statistically significant (17.86% vs.39.33%, χ2=4.363, P=0.037).Logistic regression analysis showed that hypoproteinemia, hospital stay and intranperative transfusion were the influencing factors of perioperative complications in patients undergoing radical cystectomy and double cutaneous ureterostomy (Respectively, χ2=10.131, P=0.003;χ2=8.685, P=0.012;χ2=6.675, P=0.018).Conclusion Radical cystectomy with double cutaneous ureterostomy is associated with a high perioperative comlications.Hypoproteinemia, longer hospital stay and intraoperative transfusion are independently associated with any complication in these patients.The Clavien system is a validated method that can be successfully used to stratify and evaluate perioperative complications during radical cystectomy and double cutaneous ureterostomy.

Objective To compare the diversities in serum prostate specific antigen (PSA) in different time periods between patients with benign prostatic hyperplasia (BPH) who have holmium laser enucleation of the prostate (HoLEP) and trans urethral resection prostate (TURP) separately and to analyze the factors associated with those differences.Methods A total of 135 BPH surgery cases were collected from urology department of our hospital.The serum PSA data was collected before the operation,and on the 1st,5th,9th,and 90th day after the operation.Result PSA value of HoLEP group on the 1 st,5th,9th,and 90th day after the operation were lower than those of TURP group,with statistically significant differences (P＜0.01).Conclusions Compared with the traditional TURP surgery,the serum PSA value in HoLEP group rose slightly after surgery for a short period of time,whereas it was low after three months.The HoLEP surgery produces minor damage to prostate tissue and contributes to the thorough removal of hyperplasia.

In a previous study by the present authors, it was identified that the expression of engrailed-2 (EN2) gene was downregulated in clear cell renal cell carcinoma (cc-RCC). The aim of the present study was to determine whether aberrant methylation was the mechanism underlying the silencing of EN2 gene in cc-RCC. A total of forty paired cc-RCC tissues, four cc-RCC cell lines and one normal human proximal tubule epithelial cell line were evaluated for EN2 gene methylation status using methylation-specific polymerase chain reaction (PCR). Following treatment with 5-Aza-dc, reverse transcription-quantitative PCR and western blot analysis were performed to examine the expression of EN2. Furthermore, cell proliferation, apoptosis and invasion assays were conducted to analyze the inhibitory effects of EN2 re-expression in 786-O cells. The results of the present study demonstrated that hyper-methylation of EN2 was identified in 12/40 cc-RCC tissues and all cc-RCC cell lines. The methylation status of the EN2 gene was revealed to be associated with histological grade and tumor size in cc-RCC. Following 5-Aza-dc treatment, demethylation of the EN2 gene was identified in 786-O cells, in conjunction with EN2 re-expression. Furthermore, re-activation of the EN2 gene markedly inhibited the proliferative and invasive capacities of cc-RCC. The results of the present study demonstrated that the EN2 gene promoter was hyper-methylated in cc-RCC, which may underlie the silencing of the EN2 gene in cc-RCC.

The association of varicoceles with infertility is well established, but the exact effect of varicoceles on semen quality among patients with infertility is still poorly known. The study aimed to examine the prevalence of varicoceles among Chinese men with infertility and to examine the factors associated with semen quality. This was a cross-sectional study of 5447 male patients treated for infertility at the Affiliated Hospital of Guangdong Medical University from October 2012 to December 2015. The patients were divided on the basis of the presence of varicoceles. Examinations of the amount of semen and sperm morphology were performed according to seminal parameter detection methods recommended by the World Health Organization. Patients with varicoceles (n=1429/5447, 26.2%) were slightly younger (P=.046), and had smaller testis (P=.019), higher frequency of abnormal epididymis (P<.001), slightly shorter infertility duration (P=.046), and lower frequency of smokers (P=.012). There was no difference in the distribution of occupations (P=.777). Using multiple linear regression analysis, varicoceles were shown to be independently associated with semen volume [B=-0.153, 95% confidence interval (95% CI): -0.245 to -0.062, P=.001], sperm concentration (B=9.633, 95% CI: 7.152-12.114, P<.001), proportion of sperms with normal morphology (B=0.951, 95% CI: 0.623-1.278, P<.001), motility (B=3.835, 95% CI: 2.675, 4.995, P<.001), total sperm count (B=22.481, 95% CI: 13.333-31.629, P<.001), and forward movement sperm count (B=15.553, 95% CI: 9.777-21.329, P<.001). Varicoceles were present in 26% of Chinese male patients with infertility. Varicoceles were independently associated with sperm volume, sperm concentration, proportion of sperms with normal morphology, motility, total sperm count, and forward movement sperm count.

目的:比较腰硬联合麻醉和腰硬联合麻醉加超声引导下闭孔神经阻滞在膀胱侧壁及三角区附近肿瘤经尿道膀胱肿瘤等离子电切术(TUPKR-Bt)中的临床效果.方法:回顾性研究2012年1月1日～2015年10月31日在我院泌尿外科行经尿道膀胱肿瘤电切术的98例膀胱侧壁肿瘤患者.其中48例患者单独行腰硬联合麻醉(CSEA组),50例患者行腰硬联合麻醉加超声引导下闭孔神经阻滞(CSEA+O组).结果:CSEA+O组的肿瘤切除时间(15.38±7.09)min显著短于CSEA组的(19.45±5.70)min,闭孔神经反射发生率及膀胱穿孔率显著少于CSEA组(2％vs.39.6％;0 vs.10.4％),血红蛋白下降水平(0.5±0.37)g/dL显著小于CSEA组(0.8±0.43)g/dL,膀胱刺激征发生率显著少于CSEA组(24％ vs.64.6％),留置尿管时间和住院时间显著短于CSEA组,随访期间肿瘤复发率低于CSEA组(8％vs.22.9％);输血率和术后1年肿瘤复发率两组差异无统计学意义.结论:超声引导下闭孔神经阻滞应用于TUPKR-Bt患者中,可以有效减少闭孔神经反射的发生,使切除更彻底和安全,减少术中出血,缩短住院时间,减少肿瘤复发.

Reactive oxygen species (ROS) is an important regulator in cellular signaling transduction, and many previous studies have indicated that acute ROS stimulation improves insulin sensitivity in skeletal muscle. In the study, we found that chronic ROS treatment caused serious insulin resistance in C2C12 myotubes. Glucose uptake and consumption assay indicated that pretreatment with 80 μM H2O2 for 2 h inhibited insulin-stimulated glucose uptake in C2C12 myotubes, and the reason for it, is that chronic H2O2 treatment decreased insulin-induced glucose transporter 4 (GLUT4) translocation from cell plasma to cell membrane. Moreover, Akt2 phosphorylation depended on insulin was reduced in C2C12 myotubes of chronic H2O2 treatment. Together, this study provides further demonstration that chronic ROS stress is associated with insulin resistance of skeletal muscle in the progression of type 2 diabetes.

Our preliminary study indicated that Engrailed-2 (EN2) is downregulated but also ectopically expressed in clear-cell renal cell carcinoma (CCRCC), and the absence of EN2 expression was associated with poor histological grade. However, the specific roles of EN2 in CCRCC have yet to be elucidated. In the present study, we examined the effects of inhibiting EN2 expression by human renal tubular epithelial cells (HK-2) and overexpressing EN2 by human clear-cell renal cells (786-O). Results showed that EN2 inhibition accelerated HK-2 cell proliferation, shortened the cell cycle, reduced apoptosis, and acted more invasively. By contrast, EN2 overexpression in 786-O cells decelerated the proliferative ability of 786-O, increased the percentage of cell apoptosis, and weakened the invasive ability. Overall, the results demonstrated that EN2 might play an anti-oncogenic role in oncogenesis and development of CCRCC, thereby maintaining the normal growth of human renal tubular epithelial cells.

Background The value of Fas ligand (FASL) as a diagnostic immune marker for acute renal rejection is controversial; this meta-analysis aimed to clarify the role of FASL in acute renal rejection. Methods The relevant literature was included by systematic searching the MEDLINE, EMBASE, and Cochrane Library databases. Accuracy data for acute rejection (AR) and potential confounding variables (the year of publication, area, sample source, quantitative techniques, housekeeping genes, fluorescence staining, sample collection time post-renal transplantation, and clinical classification of AR) were extracted after carefully reviewing the studies. Data were analyzed by Meta-DiSc 1.4, RevMan 5.0, and the Midas module in Stata 11.0 software. Results Twelve relevant studies involving 496 subjects were included. The overall pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR, and diagnostic odds ratio, together with the 95% CI were 0.64 (0.57-0.70), 0.90 (0.85-0.93), 5.66 (3.51-9.11), 0.30 (0.16-0.54), and 30.63 (14.67-63.92), respectively. The area under the summary receiver operating characteristic curve (AUC) was 0.9389. Fagan's nomogram showed that the probability of AR episodes in the kidney transplant recipient increased from 15% to 69% when FASL was positive, and was reduced to 4% when FASL was negative. No threshold effect, sensitivity analyses, meta-regression, and subgroup analyses based on the potential variables had a significant statistical change for heterogeneity. Conclusions Current evidence suggests the diagnostic potential for FASL mRNA detection as a reliable immune marker for AR in renal allograft recipients. Further large, multicenter, prospective studies are needed to validate the power of this test marker in the non-invasive diagnosis of AR after renal transplantation.

Apollon, namely baculoviral inhibitor of apoptosis proteins (IAP) repeat containing 6, is an unusually large member of the IAP family, and may be important in oncogenesis. The aim of the present study was to assess the association between renal carcinoma (RC) and Apollon expression, and to highlight the link between Apollon expression and the occurrence, development and prognosis of RC. Apollon expression was detected by immunohistochemistry, western blotting and reverse transcription-quantitative polymerase chain reaction in RC tissues, adjacent non-cancerous tissues and paired normal tissues, respectively, in order to analyze the association between Apollon expression and clinicopathological features of RC. Kaplan-Meier survival estimate was used to assess the prognostic significance. It was observed that Apollon expression was higher in carcinoma tissues than in adjacent non-cancerous tissues and normal control tissues at the protein and messenger RNA level (P<0.001). There was a significant difference in T-stage (P=0.006), nodal involvement (P=0.007) and tumor-node-metastasis-stage (P=0.035) in patients categorized according to different Apollon expression levels. A prognostic significance of Apollon was also identified by the Kaplan-Meier method. The results of the present study indicate that Apollon expression is associated with the biological characteristics of renal cancer, and is potentially a valuable predictor and novel target for RC.

To evaluate the efficacy and safety of transurethral enucleation of the prostate (TUEP) versus transvesical open prostatectomy (OP) for the management of large benign prostatic hyperplasia (BPH).

Objective To evaluate the effectiveness and safety of complete transperitoneal laparoscopic nephroureterectomy (CTLNU) for upper tract urothelial carcinoma (UTUC). Methods Between October 2010 and October 2015, a total of 79 patients with UTUC were assigned to receive either CTLNU (CTLNU group, n=47) or retroperitoneal laparoscopic nephroureterectomy (RLNU group, n =32).The operation time, intraoperative blood loss, postoperative anal exhaust time, and number of postoperative hospitalization days were recorded . Results As compared with the RLNU group , the operation time was significantly shorter in the CTLNU group [(120.5 ±21.6) min vs.(145.2 ±29.9) min, t =-4.265, P =0.000], the intraoperative blood loss was significantly less in the CTLNU group [(120.8 ±42.4) ml vs.(190.6 ±60.8) ml, t=-6.017, P=0.000], and the number of postoperative hospitalization days was significantly lower in the CTLNU group [(8.2 ±2.5) d vs.(9.9 ±3.2) d, t=-2.646, P=0.010].Whereas there was no significant difference in postoperative anal exhaust time between the two groups (P>0.05).There were 5 cases and 3 cases of urinary bladder epithelial cell carcinoma in the CTLNU group and the RLNU group during the follow -up, respectively (P>0.05), which were treated with bladder tumor transurethral resection .Distant metastasis was found in 2 cases in the CTLNU group and 3 cases in the RLNU group (P>0.05). Conclusion Complete transperitoneal laparoscopic nephroureterectomy is a minimally invasive, feasible, safe and effective way to treat UTUC.

Phosphatidylinositol 3-kinase (PI3K)/AKT and mitogen activated protein kinase (MAPK) signaling cascades have significant roles in cell proliferation, survival, angiogenesis and metastasis of tumor cells. Eupatilin, one of the major compounds present in Artemisia species, has been demonstrated to have antitumor properties. However, the effect of eupatilin in renal cell carcinoma (RCC) remains to be elucidated. Therefore, the present study investigated the biological effects and mechanisms of eupatilin in RCC cell apoptosis. The results of the present study demonstrated that eupatilin significantly induced cell apoptosis and enhanced the production of reactive oxygen species (ROS) in 786-O cells. In addition, eupatilin induced phosphorylation of p38α (Thr180/Tyr182), extracellular signal-regulated kinase 1/2 and c-Jun N-terminal kinase 1/2 (Thr183/Tyr185), and decreased the phosphorylation of PI3K and AKT in 786-O cells in a concentration-dependent manner. Furthermore, the ROS inhibitor N-acetyl-L-cysteine was able to rescue the MAPK activation and PI3K/AKT inhibition induced by eupatilin. Taken together, the results of the present study provide evidence that inhibition of eupatilin induces apoptosis in human RCC via ROS-mediated activation of the MAPK signaling pathway and inhibition of the PI3K/AKT signaling pathway. Thus, eupatilin may serve as a potential therapeutic agent for the treatment of human RCC.

目的 探讨肾移植术后外周血趋化因子IP-10和Fractalkine及其受体术后动态变化和早期预测肾移植排斥的应用价值. 方法 前瞻性地收集2009-01～2012-03在暨南大学附属第一医院行同种异体肾移植术的患者52例,排除感染及其他感染因素后根据术后临床表现及移植肾穿刺病理学检查,分为急性排斥反应(acute rejection,AR,n=15)组与非急性排斥(non-acute rejection,NAR,n=35)组,测定两组患者术前ld以及术后1,3,5,9d的外周血IP-10及受体CXCR3和Fractalkine及受体CX3CR1的表达情况.采用ROC曲线评价标记物准确度并计算其曲线下总面积(area under curve,AUC). 结果 共有15例在肾移植术后发生急性排斥反应(acute rejection,AR),AR组的IP-10及受体CXCR3、Fractalkine及受体CX3CR1均比术前增高,且差异有统计学意义(P＜0.05).AR组的IP-10、CXCR3及CX3CR1在术后各个检测点均显著高于NAR组,而Fractalkine在术后5d内均显著高于NAR组.IP-10在预测急性排斥反应的AUC值为0.74(95％ CI 0.57-0.91),而Fractakine则为0.75(95％ CI 0.61-0.89),联合IP-10与Fractakine预测急性排斥反应具有最大的ROC曲线下总面积,AUC值提高至0.86(95％CI 0.77-0.96). 结论 血清中趋化因子IP-10及受体、Fractalkine及受体与急性排斥反应密切相关,预测价值较高,有望成为早期诊断肾移植急性排斥反应的新型无创检测方法.