發(fā)布時間：2018-06-29 19:24

  本文選題：非小細胞肺癌 + glycodelin-A�。� 參考：《山東大學》2017年碩士論文

【摘要】：目的:非小細胞肺癌是嚴重危害人類健康的腫瘤,是全球范圍內(nèi)引起癌癥死亡的首要原因,患者生存差,迫切需要新的因子來預測患者的生存,以制定個體化的治療方案。目前有多項研究發(fā)現(xiàn)腫瘤細胞可產(chǎn)生glycodelin-A,glycodelin-A的表達與患者的不良預后相關(guān)。在非小細胞肺癌患者的研究中,并無明確結(jié)論。本研究使用了 125例非小細胞肺癌患者的資料,使用免疫組化法檢測glycodelin-A的表達,并分析了 glycodelin-A與患者臨床病理學特征之間的關(guān)系,以及glycodelin-A表達對于非小細胞肺癌患者生存的影響。方法:免疫組化法檢測每個患者的glycodelin-A表達情況并記錄,使用卡方檢驗分析glycodelin-A與患者性別、年齡、吸煙史、病理類型、組織學分級、TNM分期、有無淋巴結(jié)轉(zhuǎn)移的關(guān)系,使用Kaplan-Meier法及COX單因素、多因素分析法進行生存分析。結(jié)果:1、Glycodelin-A在肺癌組織中陽性率為27.2%,在癌旁肺組織中陽性率為11.2%,glycodelin-A在肺癌組織中陽性率較癌旁組織明顯增多,P=0.035。2、患者Glycodelin-A表達情況和TNM分期有關(guān)系,而與患者的性別、年齡、吸煙史、病理類型、分化程度、是否有淋巴結(jié)轉(zhuǎn)移這些因素無關(guān)。3、kaplan-meier法和單因素COX模型對于無進展生存期有意義的影響因素結(jié)論一致。對于無進展生存期有意義的有:肺癌TNM分期、glycodelin-A蛋白表達情況、是否經(jīng)過手術(shù)治療、淋巴結(jié)轉(zhuǎn)移與否。對于總生存期,kaplan-meier法顯示有意義的是:肺癌TNM分期、glycodelin-A蛋白表達情況、是否經(jīng)過手術(shù)治療、淋巴結(jié)轉(zhuǎn)移與否。4、COX多因素分析結(jié)果顯示:手術(shù)是影響患者無進展生存期(p=0.001)的獨立因子。吸煙史(p=1.117)、手術(shù)治療(p0.001)是影響患者總生存期的獨立因子。5、在男性患者、年齡≥60歲的患者、吸煙患者、鱗癌患者、Ⅲ期患者、低分化患者以及有淋巴結(jié)轉(zhuǎn)移的患者,表達glycodelin-A的患者有更短的無進展生存期和總生存期。結(jié)論:1、Glycodelin-A的表達情況和患者的TNM分期有關(guān)。2、Glycodelin-A陽性表達的患者有更短的無進展生存期和總生存期。3、Glycodelin-A不是無進展生存期和總生存期的獨立預后因子。4、TNM分期、是否經(jīng)過手術(shù)治療、患者淋巴結(jié)轉(zhuǎn)移與否也是影響患者無進展生存期和總生存期的因子。5、手術(shù)治療是患者無進展生存期的獨立預后因子。吸煙史、手術(shù)治療是患者總生存期的獨立預后因子。
[Abstract]:Objective: Non-small cell lung cancer (NSCLC) is a major cause of cancer death in the world and it is a serious threat to human health. Patients with NSCLC have poor survival and need new factors to predict the survival of NSCLC patients so as to formulate individualized treatment schemes. Several studies have found that the expression of glycodelin-A in tumor cells is related to the poor prognosis of patients. There is no clear conclusion in the study of patients with non-small cell lung cancer. The data of 125 patients with non-small cell lung cancer were used to detect the expression of glycodelin-A by immunohistochemical method. The relationship between glycodelin-A and clinicopathological features was analyzed. And the effect of glycodelin-A expression on the survival of patients with non-small cell lung cancer. Methods: immunohistochemical method was used to detect and record the expression of glycodelin-A in each patient. The relationship between glycodelin-A and sex, age, smoking history, pathological type, histological grade and lymph node metastasis was analyzed by chi-square test. Kaplan-Meier method and Cox single factor analysis were used to analyze survival. Results the positive rate of Glycodelin-A and glycodelin-A in lung cancer tissues and adjacent lung tissues was 27.2 and 11.2 respectively. The positive rate of glycodelin-A in lung cancer was significantly higher than that in adjacent tissues. The expression of Glycodelin-A was correlated with TNM staging, but it was related to sex, age and smoking history. Pathological type, degree of differentiation and lymph node metastasis were not related to the correlation between the single factor Cox model and the single factor Cox model. The significance of progression free survival is the expression of glycodelin-A protein in TNM staging of lung cancer, surgical treatment, lymph node metastasis or not. The expression of glycodelin-A protein in TNM staging, surgical treatment, lymph node metastasis, multivariate analysis showed that surgery was an independent factor affecting the progression free survival (p0.001) of patients with lung cancer by using kaplan-meier method. Smoking history (p1. 117), surgical treatment (p0. 001) were independent factors affecting the overall survival of patients. In male patients, patients over 60 years of age, smoking patients, squamous cell carcinoma patients, stage 鈪，

本文編號：2083115