發(fā)布時(shí)間：2018-04-19 17:09

  本文選題：肝細(xì)胞癌 + 病理分級(jí)�。� 參考：《右江民族醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:探討肝細(xì)胞癌術(shù)前CT表現(xiàn)與癌組織CD34、GPC-3、HSP70蛋白表達(dá)水平、病理分級(jí)、患者預(yù)后的相關(guān)性。方法:搜集右江民族醫(yī)學(xué)院附屬醫(yī)院2013年7月至2015年8月在我院經(jīng)病理證實(shí)為肝細(xì)胞癌的患者62例,所有病例術(shù)前行CT平掃及3期增強(qiáng)掃描,所有患者都有完整的隨訪資料,隨訪至2016年8月1日;運(yùn)用免疫組織化學(xué)法檢查癌組織中CD34、GPC-3、HSP70的蛋白表達(dá)水平;通過對(duì)比患者術(shù)前CT表現(xiàn)與術(shù)后切除癌組織CD34、GPC-3、HSP70的蛋白表達(dá)水平、病理分級(jí)及患者的生存時(shí)間,統(tǒng)計(jì)分析其是否存在相關(guān)性。結(jié)果:本研究62例HCC患者中肝癌的大小、瘤內(nèi)出血壞死、動(dòng)脈期腫瘤血管強(qiáng)化與CD34的表達(dá)水平存在相關(guān)性(P0.05);肝癌的大小、動(dòng)脈期腫瘤血管強(qiáng)化及肝癌的供血類型與GPC-3表達(dá)水平存在相關(guān)性(P0.05);不同供血類型的肝癌HSP70的表達(dá)水平存在差異(P0.05);肝癌的大小、邊緣、瘤內(nèi)出血壞死與其病理分化程度相關(guān)(P0.05);肝癌的病理分化程度越低,GPC-3及HSP70的表達(dá)水平越高。CT征象中表現(xiàn)為有侵襲轉(zhuǎn)移組及病理分化較低組患者的平均生存時(shí)間明顯低于無侵襲轉(zhuǎn)移組及病理分化較高組(15.4月vs28.2月,24.2月vs27.2月),差異有統(tǒng)計(jì)學(xué)意義(P0.05);雖然邊緣模糊組生存時(shí)間低于邊緣清楚組(20.4月vs28.5月),瘤內(nèi)有出血壞死組生存時(shí)間低于無出血壞死組(24.1月vs31月),但差異并無統(tǒng)計(jì)學(xué)意義。結(jié)論:肝癌的CT表現(xiàn)可在一定程度上反映癌組織中CD34、GPC3、HSP70的蛋白表達(dá)水平;CD34、GPC3、HSP70的蛋白表達(dá)水平可以在一定程度上反映肝癌的病理分化程度;肝癌的CT表現(xiàn)可以反映癌組織的病理分化程度;CT征象中表現(xiàn)為有侵襲轉(zhuǎn)移者及病理分化較低患者的預(yù)后較差。
[Abstract]:Objective: to investigate the correlation between preoperative CT findings and expression of CD34 GPC-3 HSP70 protein, pathological grade and prognosis of hepatocellular carcinoma (HCC).Methods: from July 2013 to August 2015, 62 patients with hepatocellular carcinoma (HCC) confirmed by pathology were collected from affiliated Hospital of Youjiang Medical College for nationalities. All patients underwent plain CT scan and 3 phase enhanced CT scan before operation, and all patients had complete follow-up data.All patients were followed up until Aug. 1, 2016. The expression of CD34GPC-3HSP70 was detected by immunohistochemical method, and the expression of CD34GPC-3HSP70 was compared with that of postoperative excision of CD34GPC-3HSP70, and the pathological grade and survival time of the patients were compared.Statistical analysis of its relevance.Results: in 62 patients with HCC, there was a correlation between tumor angiogenesis and CD34 expression, the size of HCC, the size of HCC, and the size of HCC.In arterial phase, there was a correlation between vascular enhancement and the blood supply type of HCC and the expression level of GPC-3, the expression level of HSP70 in different blood supply type of HCC was different (P0.05), the size and edge of HCC, the size of HCC, the margin of HCC, the size of HCC, the size of HCC, the margin of HCC,The expression of GPC-3 and HSP70 was higher in HCC with lower degree of pathological differentiation. Ct findings showed that the mean survival time of patients with invasion and metastasis was significantly higher than that of patients with lower pathological differentiation.It was lower than that of non-invasive metastasis group and higer pathological differentiation group (15.4 vs28.2 months, 24.2 months vs27.2 month, the difference was statistically significant P 0.05), although the survival time of fuzzy margin group was lower than that of clear margin group (20.4 vs28.5 month), the survival time of tumor with hemorrhage necrosis group was lower than that of clear margin group (20.4 vs28.5 month).In the group without hemorrhage necrosis (24.1 vs31), the difference was not statistically significant.Conclusion: Ct findings of HCC can reflect the expression level of GPC3HSP70 in HCC to a certain extent. The expression level of HSP70 in CD34GPC3hSP70 can reflect the degree of pathological differentiation of HCC to some extent.Ct findings of hepatocellular carcinoma can reflect the degree of pathological differentiation of carcinoma. The prognosis of patients with invasion and metastasis and patients with poor pathological differentiation is poor.
【學(xué)位授予單位】：右江民族醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.7;R730.44

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本文編號(hào)：1773977