【摘要】：目的：宮頸癌在女性惡性腫瘤中排名第二，基本分為腺癌和鱗癌，宮頸腺癌的發(fā)生率要明顯低于宮頸鱗癌，據(jù)統(tǒng)計顯示腺癌約占宮頸癌的5%-8%，但近年來，有研究表明，宮頸腺癌的發(fā)病率有所增加，由于宮頸腺癌，不容易被發(fā)現(xiàn)等原因，使宮頸腺癌的預后遠遠差于宮頸鱗狀細胞癌，對于宮頸腺癌做出準確的病理診斷對于指導臨床尤為重要，本實驗主要是研究人角化層糜蛋白酶（stratumcorneum chymotryptic enzyme, SCCE），絨毛蛋白（Villin）在宮頸腺癌發(fā)展過程的各階段中的表達情況，并分析它們對于診斷宮頸腺癌及判斷預后的重要意義。 方法：采用免疫組織化學法檢測宮頸腺癌45例、宮頸腺上皮內(nèi)瘤變（cervicalglandular intraepithelial neoplasia, CGIN）24例和正常宮頸組織24例中SCCE，Villin的表達及45例宮頸腺癌中雌激素受體（estrogen receptor，ER）、癌胚抗原（carcino-embryonic antigen，CEA）、波形蛋白（Vimentin）的表達情況，采用Western blotting方法檢測10例宮頸腺癌和5例正常宮頸組織中SCCE、Villin的表達情況，結合患者臨床病理資料和出院后的隨訪情況，統(tǒng)計學分析SPSS16.0統(tǒng)計軟件包進行。以P0.05為差異有統(tǒng)計學意義。 結果： 1免疫組織化學染色結果 1.1SCCE、Villin在宮頸腺癌、宮頸腺上皮內(nèi)瘤變和正常宮頸中的表達 對免疫組化結果進行統(tǒng)計學分析：SCCE、 Villin蛋白在宮頸腺癌組、CGIN組中的表達與正常宮頸組的表達比較，進行統(tǒng)計學分析，差異具有顯著性（P0.05），宮頸腺癌組與CGIN組間比較，差異無顯著性（P＞0.05）。 1.2SCCE、Villin在宮頸腺癌中的表達情況與宮頸腺癌中ER、CEA、Vimentin表達的相關性 對免疫組化結果進行統(tǒng)計學分析：SCCE表達與Villin呈正相關（r=0.434，P0.05)、與Vimentin呈負相關（r=㧟0.373，P0.05)、與ER呈負相關（r=㧟0.629，P0.05)、與CEA表達呈正相關（r=0.434，P0.05)（見表3）；Villin表達與Vimentin呈負相關（r=㧟0.484，P0.05)、與ER呈負相關（r=㧟0.883，P0.05)、與CEA表達呈正相關（r=0.775，P0.05)（見表4）。 1.3SCCE、Villin的表達與宮頸腺癌臨床病理參數(shù)之間的關系 SCCE、Villin在宮頸腺癌I期中表達率低于II+III+IV期中的表達率，差異有顯著性，具有統(tǒng)計學意義（P0.05），在高分化宮頸腺癌中的表達率低于中、低分化宮頸腺癌中的表達率，差異有顯著性，具有統(tǒng)計學意義（P0.05），在有淋巴結轉移的宮頸腺癌中的表達率高于沒有發(fā)生淋巴結轉移患者的表達率，差異有顯著性，具有統(tǒng)計學意義（P0.05）。 1.4宮頸腺癌預后的多因素分析 Cox比例風險模型多因素分析顯示：臨床分期、組織分級、淋巴結轉移情況及SCCE的表達情況可以顯著影響宮頸腺癌患者的生存時間（P0.05），但Villin的表達情況對宮頸腺癌患者生存時間的影響不大。 1.5SCCE、Villin蛋白的表達及臨床病理參數(shù)與宮頸腺癌預后的單因素分析 臨床分期I期組，組織分級高分化組，淋巴結未發(fā)生轉移組，SCCE陰性表達組的生存率顯著高于臨床分期II+III+IV期組，組織分級中、低分化組，，淋巴結發(fā)生轉移組，SCCE陽性表達組的生存率，并且差異有顯著性，具有統(tǒng)計學意義（P0.05）。 2Western blot結果 SCCE、Villin在宮頸腺癌組中表達率顯著高于正常宮頸組（P0.05),差異有顯著性，具有統(tǒng)計學意義。 結論 1、SCCE、Villin在正常宮頸、CGIN和宮頸腺癌組中的表達率是呈上升趨勢；在宮頸腺癌中，隨著臨床分期的增加、組織分級的降低及淋巴結轉移的發(fā)生，SCCE、Villin的表達率都是逐漸升高的，說明SCCE及Villin的表達可能與宮頸腺癌的發(fā)生、發(fā)展及轉移有關。 2、SCCE、Villin、ER、CEA及Vimentin聯(lián)合檢測可以提高宮頸腺癌的診斷準確率。 3、SCCE的表達可以作為判斷宮頸腺癌患者預后的指標之一。
[Abstract]:Objective: Cervical cancer is the second in the female malignant tumor, which is mainly divided into adenocarcinoma and squamous cell carcinoma. The incidence of cervical adenocarcinoma is lower than that of the cervical squamous cell carcinoma. According to the statistics, it shows that the adenocarcinoma is about 5% to 8% of the cervical cancer, but in recent years, it has been shown that the incidence of cervical adenocarcinoma has increased. Because cervical adenocarcinoma is not easy to be found, the prognosis of cervical adenocarcinoma is much worse than that of the cervical squamous cell carcinoma. The expression of Villin in the development of cervical adenocarcinoma was analyzed and their significance in the diagnosis of cervical adenocarcinoma and the prognosis was also analyzed. Methods:45 cases of cervical adenocarcinoma,24 cases of cervical intraepithelial neoplasia (CGIN) and 24 cases of normal cervical tissue,24 cases of cervical intraepithelial neoplasia (CGIN) and 24 cases of normal cervical tissue were used to detect the expression of SCCE, Villin and the expression of estrogen receptor (ER), carcinoembryonic antigen (CEA) in 45 cases of cervical adenocarcinoma. The expression of Vimentin and the expression of SCCE and Villin in 10 cases of cervical adenocarcinoma and 5 normal cervical tissues were detected by Western blotting. Line. There is a statistical meaning for the difference in the difference of P0.05 Righteousness. Results:1 immune tissue Chemical staining results 1.1 SCCE, Villin in cervical adenocarcinoma, cervical intraepithelial neoplasia and The expression of SCCE and Villin in the cervical adenocarcinoma group and the CGIN group was analyzed by the expression of SCCE and Villin in the normal cervical carcinoma. There was no significant difference between the cervical adenocarcinoma group and the CTIN group, and the difference was not significant between the cervical adenocarcinoma group and the CGIN group. (P> 0.05). 1.2 The expression of SCCE and Villin in the cervical adenocarcinoma and the ER, CEA, Vi in the cervical adenocarcinoma The correlation of mentin expression was found to be positively correlated with Villin (r = 0.434, P0.05), and negative correlation with Vimentin (r = 0.373, P0.05), and negative correlation with ER (r = 0.434, P <0.05). ? 0.629, P0.05), positive correlation with the expression of CEA (r = 0.434, P0.05) (see Table 3), negative correlation with Vimentin (r =-0.484, P0.05), negative correlation with ER (r =-0.883, P0.05), and positive correlation with the expression of CEA (r = 0.77). 5, P0.05) (see Table 4). 1.3 Expression of SCCE and Villin The relationship between the clinicopathological parameters of cervical adenocarcinoma and the expression rate of Villin in the phase I of cervical adenocarcinoma was lower than that in the II + III + IV phase, and the difference was significant (P0.05). The expression rate of the high-differentiated cervical adenocarcinoma was lower than that of the medium and the low-differentiated cervical adenocarcinoma, and the difference was significant (P0.05). The expression rate in the cervical adenocarcinoma with lymph node metastasis was higher than that of the patients without lymph node metastasis. It is of statistical significance (P 0.0). 5).4. The multi-factor analysis of the Cox proportional risk model for the prognosis of cervical adenocarcinoma showed that the clinical stage, the histological grade, the lymph node metastasis and the expression of SCCE could be displayed. The survival time of patients with cervical adenocarcinoma was affected (P0.05), but Vilin The effect of the expression of the expression on the survival time of the patients with cervical adenocarcinoma was not significant. The single-factor analysis of the expression of white and the clinicopathological parameters and the prognosis of cervical adenocarcinoma showed that the survival rate of the SCCE-negative expression group was significantly higher in the stage I, the high-differentiation group, the non-metastasis group and the SCCE-negative expression group. Bed stage II + III + IV group, tissue grade, low differentiation group, lymph node metastasis group, SCCE positive expression group's survival The rate, and the difference is significant, has a series The expression rate of SCCE and Villin in the cervical adenocarcinoma group was significantly higher than that of the Western blot. above Conclusion: The expression rate of SCCE and Villin in the normal cervical, CGIN and cervical adenocarcinoma group is on the rise. In the cervical adenocarcinoma, with the increase of clinical stage, the grade of the tissue is decreased. The expression rate of SCCE and Villin was gradually increased, and the expression rate of SCCE and Villin was gradually increased. The expression of SCCE and Villin may be related to the occurrence, development and metastasis of cervical adenocarcinoma. The combination of n, ER, CEA and Vimentin can improve the cervical adenocarcinoma
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R737.33

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