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  本文選題：肝細(xì)胞肝癌　切入點(diǎn)：肝內(nèi)膽管細(xì)胞癌　出處：《山西醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討三種肝癌分別為肝細(xì)胞肝癌和肝內(nèi)膽管細(xì)胞癌和結(jié)節(jié)性肝硬化中GPC3、AFP的表達(dá)并且比較GPC3、AFP在肝三種肝癌中表達(dá)的差異。方法:通過對總共92例患者的分別比較50例原發(fā)性肝細(xì)胞肝癌、20例肝內(nèi)膽管細(xì)胞癌、22例結(jié)節(jié)性肝硬化的細(xì)胞,采用免疫組織化學(xué)方法對92例患者手術(shù)切除標(biāo)本中細(xì)胞進(jìn)行GPC3、AFP檢測,檢測GPC3在三種肝癌不同時期和分化的陽性表達(dá)情況,比較GPC3、AFP在三種肝癌中表達(dá)的差異。結(jié)果:肝細(xì)胞肝癌的細(xì)胞中GPC3特異性表達(dá)且具有敏感性,敏感性分別為84.0%、97.7%,與其余兩種肝癌中GPC3的表達(dá)相比,兩者差異有統(tǒng)計學(xué)意義(P0.05)。肝細(xì)胞肝癌中細(xì)胞GPC3蛋白的表達(dá)與患者各個方面的差異無統(tǒng)計學(xué)意義(P0.05)。在三種分期的肝細(xì)胞肝癌中GPC3的陽性率分別為82.4%、84.9%,均明顯高于肝細(xì)胞肝癌中AFP蛋白的表達(dá),兩者相比較差異具有統(tǒng)計學(xué)意義(P0.05)。肝細(xì)胞肝癌中的GPC3和AFP兩者聯(lián)合,就能檢測并且診斷極早期+早期、中期+進(jìn)展期肝細(xì)胞肝癌,檢測和診斷的敏感性提高為88.2%、87.8%。三種不同程度分化的肝細(xì)胞肝癌中的GPC3蛋白的陽性率分別為75.0%、85.0%、81.8%,均明顯高于肝細(xì)胞肝癌中AFP這種蛋白的表達(dá),差異具有統(tǒng)計學(xué)意義(P0.05)。三種分化程度的肝細(xì)胞肝癌中GPC3和AFP兩者聯(lián)合檢測可將診斷陽性率的敏感性提高為75.0%、90.0%、90.9%。GPC3肝內(nèi)膽管細(xì)胞癌各個分期相比,各種分期的肝內(nèi)膽管細(xì)胞癌中的GPC3陽性率分別為0%、6.25%,與肝內(nèi)膽管細(xì)胞癌中AFP蛋白的表達(dá)相比,無明顯統(tǒng)計學(xué)差異(P0.05)。不同分化程度的肝細(xì)胞肝癌中GPC3的陽性率分別為25.0%、0%、0%,與肝內(nèi)膽管細(xì)胞癌中AFP蛋白的表達(dá)相比無明顯統(tǒng)計學(xué)差異(P0.05)。結(jié)論:肝細(xì)胞肝癌中細(xì)胞中GPC3高表達(dá)并且可能參與肝細(xì)胞肝癌的產(chǎn)生和進(jìn)展。GPC3高表達(dá)于肝細(xì)胞肝癌組織中,對早期肝細(xì)胞肝癌診斷的重要提示作用,對于區(qū)分良性及惡性早期占位性病變重要提示作用。
[Abstract]:Objective: to investigate the expression of GPC3P AFP in hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (HCC) and nodular cirrhosis (LC) and to compare the difference of GPC3 AFP expression in hepatocarcinoma. Methods: a total of 92 patients were enrolled in this study. The cells of 20 cases of intrahepatic cholangiocarcinoma and 22 cases of nodular liver cirrhosis were compared in 50 cases of primary hepatocellular carcinoma (HCC) and 20 cases of intrahepatic cholangiocarcinoma. Immunohistochemical method was used to detect the expression of GPC3 in the cells of 92 patients undergoing surgical resection, and the positive expression of GPC3AFP was detected at different stages and differentiation of three kinds of liver cancer. Results: the expression of GPC3 in HCC cells was specific and sensitive, and the sensitivity was 84.0 and 97.7, respectively, compared with the expression of GPC3 in the other two types of HCC. The difference was statistically significant (P 0.05). There was no significant difference between the expression of GPC3 protein in hepatocellular carcinoma and all aspects of the patients. The positive rates of GPC3 in the three stages of HCC were 82.4% and 84.9%, respectively, which were significantly higher than those in the fine liver tissue. Expression of AFP protein in hepatocellular carcinoma, The combination of GPC3 and AFP in hepatocellular carcinoma can detect and diagnose very early and middle stage advanced hepatocellular carcinoma. The sensitivity of detection and diagnosis was increased to 87.8%. The positive rates of GPC3 protein in the three kinds of differentiated hepatocellular carcinoma were 75.0% and 85.0%, respectively, which were significantly higher than the expression of AFP protein in hepatocellular carcinoma (HCC). The difference was statistically significant (P 0.05). The combined detection of GPC3 and AFP in three kinds of hepatocellular carcinoma with different degrees of differentiation could increase the sensitivity of the positive rate to 75.0% and 90.9%, compared with each stage of intrahepatic cholangiocarcinoma. The positive rates of GPC3 in various stages of intrahepatic cholangiocarcinoma were 0 and 6.25, respectively, compared with the expression of AFP protein in intrahepatic cholangiocarcinoma. The positive rates of GPC3 in hepatocellular carcinoma with different differentiation degrees were 25.0 and 25.0, respectively. There was no significant difference between the expression of AFP protein and that of intrahepatic cholangiocarcinoma. Conclusion: the expression of GPC3 in hepatocellular carcinoma is not significantly different from that in intrahepatic cholangiocarcinoma. Conclusion: there is no significant difference in the expression of AFP protein between HCC and HCC. Conclusion: there is no significant difference in the expression of AFP protein between HCC and HCC. High expression and may be involved in the production and progression of hepatocellular carcinoma. GPC3 is highly expressed in hepatocellular carcinoma. It is important to diagnose early hepatocellular carcinoma and to distinguish benign and malignant early occupying lesions.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R735.7

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