本文關(guān)鍵詞：乳腺癌多模態(tài)影像診斷及其相關(guān)生物學(xué)指標(biāo)的分析研究　出處：《新疆醫(yī)科大學(xué)》2017年博士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 乳腺癌 組蛋白去甲基化酶KDM3A 人類表皮生長因子HER-2 錐體束乳腺CT 乳腺鉬靶檢查

【摘要】：目的:綜合應(yīng)用多模態(tài)影像手段分析乳腺癌的表現(xiàn)及其相關(guān)生物學(xué)指標(biāo),用常規(guī)影像手段及新型手段分別評價對乳腺癌的診斷價值及和常見相關(guān)生物學(xué)指標(biāo)的意義,然后探討去甲基化組蛋白酶這種基因與常見生物學(xué)指標(biāo)ER、PR、HER2之間的關(guān)系及臨床表達(dá)意義,旨在為乳腺癌的預(yù)后及治療提供新的參考依據(jù)。方法:1)通過對243例乳腺癌的鉬靶影像表現(xiàn)相關(guān)特點(diǎn)及相關(guān)生物學(xué)指標(biāo)ER、PR、HER-2的表達(dá)進(jìn)行回顧性分析,探討乳腺癌X線征象與ER/PR/HER2表達(dá)之間的相關(guān)性;2)共46例乳腺癌患者的標(biāo)本經(jīng)實(shí)驗(yàn)室設(shè)計(jì)的錐體束乳腺CT掃描,每例患者均在六個月內(nèi)進(jìn)行乳腺鉬靶檢查,觀察指標(biāo)為:乳腺腫瘤的邊界,形態(tài),鈣化,周圍浸潤的情況。對相關(guān)指標(biāo)與金標(biāo)準(zhǔn)進(jìn)行對照比較;3)應(yīng)用免疫組織化學(xué)的方法,從組織水平統(tǒng)計(jì)分析在浸潤性乳腺癌中KDM3A與臨床病理參數(shù)、雌激素受體、孕激素受體、人類表皮生長因子受體2的相關(guān)性以及分析KDM3A對浸潤性乳腺癌患者生存率的影響。結(jié)果:1)X線鉬靶表現(xiàn):單純腫塊多見于Luminal A型;單純鈣化多見于Luminal B型和Her-2過表達(dá)型;局部致密伴鈣化及結(jié)構(gòu)扭曲伴鈣化病變多見于Her-2過表達(dá)型。Her-2過表達(dá)型、LuminalB型乳腺癌單純鈣化比例較多,Her-2過表達(dá)型乳腺癌鈣化多呈細(xì)小多型性,區(qū)域性分布,Luminal A型乳腺癌鈣化以不定型和細(xì)小多型性多見;2)鉬靶和錐體束乳腺CT兩種檢查方式在鈣化、毛刺及形態(tài)的檢出方面無顯著統(tǒng)計(jì)學(xué)差異。在觀察乳腺癌侵襲性的指標(biāo)時有統(tǒng)計(jì)學(xué)差異;3)KDM3A蛋白在乳腺癌中高表達(dá),KDM3A在乳腺癌組織中的表達(dá)與患者的年齡、臨床分期、病理分級、淋巴結(jié)轉(zhuǎn)移個數(shù)、腫瘤大小關(guān)系無統(tǒng)計(jì)學(xué)意義(P0.05)。KDM3A蛋白在乳腺癌中的表達(dá)與HER2的表達(dá)成正相關(guān),與ER、PR蛋白表達(dá)呈負(fù)相關(guān)。綜合多因素分析,臨床分期、PR、KDM3A可以作為乳腺癌生存的綜合因素考慮。結(jié)論:1)乳腺癌的數(shù)字化X線表現(xiàn)可一定程度上預(yù)測其分子亞型,為臨床治療及判斷其預(yù)后提供影像學(xué)方面的根據(jù),具備潛在的臨床推廣應(yīng)用價值;2)在現(xiàn)有的參數(shù)條件下,錐體束乳腺CT(CBCT)在觀察乳腺癌侵襲性是有一定的優(yōu)勢,對于乳腺癌邊界和鈣化的顯示并沒有呈現(xiàn)出明顯優(yōu)勢,但是其空間定位的優(yōu)勢是明顯的,這是我們需要進(jìn)一步研究的突破點(diǎn),錐體束乳腺CT應(yīng)用于臨床還需要更多的實(shí)踐;3)在浸潤性乳腺癌中KDM3A的表達(dá)水平與ER、PR、HER2表達(dá)水平無關(guān),檢測其蛋白表達(dá)情況對判斷患者預(yù)后具有一定意義,為臨床提供一個判斷預(yù)后的新指標(biāo)。
[Abstract]:Objective: to analyze the manifestation of breast cancer and its related biological indexes by multimodal imaging. The diagnostic value and the significance of common biological indexes of breast cancer were evaluated by conventional imaging and new methods, and then the gene of demethylated cathepsin and ERP PR, a common biological index, were discussed. The relationship between HER2 and clinical expression. Objective to provide a new reference for the prognosis and treatment of breast cancer. Methods the features of molybdenum target imaging and the relative biological index ERP PR were studied in 243 cases of breast cancer. The expression of HER-2 was analyzed retrospectively to explore the correlation between X-ray signs and ER/PR/HER2 expression in breast cancer. 2) A total of 46 samples of breast cancer were scanned by CT of pyramidal tract designed by laboratory. Mammography was performed in each patient within six months. The observed indexes were: the boundary, morphology and calcification of breast tumor. The relative indexes were compared with the gold standard. 3) KDM3A and clinicopathological parameters, estrogen receptor and progesterone receptor in invasive breast cancer were analyzed by immunohistochemical method. The correlation of human epidermal growth factor receptor 2 and the effect of KDM3A on the survival rate of invasive breast cancer patients were analyzed. Simple calcification was found in Luminal B type and Her-2 overexpression type. Local dense lesions with calcification and structural distortion with calcification were more common in Her-2 overexpression type. Her-2 overexpression type B breast cancer than in Luminal B type breast cancer. The calcification of Her-2 overexpression type breast cancer was mostly small polymorphic, and the regional distribution of luminal A type of breast cancer calcification was not stereotyped and small polymorphic. 2) there was no significant difference in calcification, burr and morphology between molybdenum target and pyramidal beam mammary CT. 3The high expression of KDM3A protein in breast cancer. The expression of KDM3A protein in breast cancer tissues and the age, clinical stage, pathological grade and number of lymph node metastasis. There was no significant difference in the relationship between tumor size and tumor size. The expression of P0.05N. KDM3A protein in breast cancer was positively correlated with the expression of HER2, and correlated with ER. The expression of PR protein was negatively correlated. KDM3A can be considered as a comprehensive factor for survival of breast cancer. Conclusion the digital X-ray findings of breast cancer can predict its molecular subtype to some extent. It provides imaging basis for clinical treatment and judgment of prognosis, and has potential clinical application value. 2) under the existing parameter condition, the cone bundle mammary CTB CT has the certain superiority in observing the breast cancer invasiveness, but has not shown the obvious superiority to the breast cancer boundary and the calcification display. However, the advantages of spatial localization are obvious, which is the breakthrough point that we need to further study. The application of cone-bundle mammary CT in clinic still needs more practice. 3) in invasive breast cancer, the expression of KDM3A was not related to the expression of ERP / HER2. Detection of the expression of HER2 protein was of significance in judging the prognosis of patients with invasive breast cancer. To provide a new prognostic index for clinical.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2017
【分類號】：R737.9;R730.44

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