本文關(guān)鍵詞： 子宮內(nèi)膜癌 脂聯(lián)素 血清胰島素 胰島素抵抗指數(shù)　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過病例-對照研究,分析子宮內(nèi)膜癌患者中血清脂聯(lián)素的表達水平,探討血清脂聯(lián)素與子宮內(nèi)膜癌發(fā)生發(fā)展之間的關(guān)系及其與胰島素抵抗指數(shù)(HOMA-IR)的相關(guān)性。方法:選取2015年10月至2016年12月在廣西醫(yī)科大學(xué)附屬腫瘤醫(yī)院婦瘤科住院患者89例:新發(fā)子宮內(nèi)膜癌患者59例為病例組,正常子宮內(nèi)膜患者30例為對照組。分別采用酶聯(lián)免疫法(ELISA)檢測血清脂聯(lián)素(adiponectin,ADP)表達情況,葡萄糖氧化酶法測定空腹血葡萄糖(fasting blood gloucse,FBG)水平,直接化學(xué)發(fā)光法測定空腹血清胰島素(fasting serum insulin,FINS)水平。通過檢測正常子宮內(nèi)膜和子宮內(nèi)膜癌患者血清脂聯(lián)素、FBG和FINS水平,計算穩(wěn)態(tài)模型胰島素抵抗指數(shù)(HOMA-IR),進而比較HOMA-IR及血清脂聯(lián)素在兩組患者中表達情況、兩者間的相關(guān)關(guān)系及血清脂聯(lián)素在子宮內(nèi)膜癌發(fā)生發(fā)展中的作用。應(yīng)用SPSS19.0進行統(tǒng)計分析。結(jié)果:1、血清脂聯(lián)素水平在病例組中為(9.13±8.79)μg/ml顯著低于對照組(16.95±15.74)μg/ml(P0.01);FINS水平在病例組中為(8.02±3.33)μU/ml顯著高于對照組(6.13±2.94)μU/ml(P0.01);HOMA-IR在病例組中為(1.74±0.97)明顯高于對照組(1.29±0.77)(P0.05);FBG在兩組中比較差別無統(tǒng)計學(xué)意義(P0.05)。2、在非肥胖患者中,血清脂聯(lián)素在子宮內(nèi)膜癌患者中含量明顯低于對照組(P0.05)。3、單因素分析結(jié)果顯示:血清脂聯(lián)素、FINS、HOMA-IR可能為子宮內(nèi)膜癌的影響因素。調(diào)整可能與子宮內(nèi)膜癌發(fā)生有關(guān)的危險因素后,低血清脂聯(lián)素水平是不依賴胰島素抵抗的影響子宮內(nèi)膜癌發(fā)生的獨立危險因素(OR=0.869,95%CI:0.807-0.936)。且其對子宮內(nèi)膜癌發(fā)生危險的影響呈劑量-反應(yīng)關(guān)系。4、血清脂聯(lián)素水平分別在子宮內(nèi)膜癌患者不同的手術(shù)-病理分期、組織學(xué)分級、病理分型、肌層浸潤深度、宮頸受累、淋巴結(jié)轉(zhuǎn)移中比較,差異均無統(tǒng)計學(xué)意義(均P0.05)。5、Spearman相關(guān)分析顯示血清脂聯(lián)素水平與HOMA-IR無明顯相關(guān)性(r=-0.134,P0.05)。結(jié)論:1、子宮內(nèi)膜癌患者的血清脂聯(lián)素水平下降;非肥胖的子宮內(nèi)膜癌患者血清脂聯(lián)素水平降低。2、低血清脂聯(lián)素水平是子宮內(nèi)膜癌發(fā)生的獨立危險因素,其對子宮內(nèi)膜癌發(fā)生危險的影響呈劑量-反應(yīng)關(guān)系。3、血清脂聯(lián)素水平與子宮內(nèi)膜癌的手術(shù)-病理分期、組織學(xué)分級、病理分型、宮頸受累、淋巴結(jié)轉(zhuǎn)移、肌層浸潤深度無相關(guān)性。4、本研究尚未發(fā)現(xiàn)子宮內(nèi)膜癌患者中低血清脂聯(lián)素水平與HOMA-IR之間的相關(guān)性。
[Abstract]:Objective: through case-control study, analysis of the expression levels of serum adiponectin in patients with endometrial cancer, serum adiponectin and endometrial carcinogenesis and the relationship between the development of insulin resistance index (HOMA-IR) correlation. Methods: from October 2015 to December 2016 in the Department of gynecology oncology Affiliated Hospital of Guangxi Medical University, 89 patients with newly diagnosed in patients with endometrial carcinoma in 59 cases as the case group, with 30 cases of normal endometrium were used as control group. Enzyme linked immunosorbent assay (ELISA) detection of serum adiponectin (adiponectin, ADP) expression, determination of fasting blood glucose by glucose oxidase method (fasting blood gloucse, FBG) level, fasting serum insulin determination of direct chemiluminescence method (fasting serum insulin, FINS) level. Through the detection of normal endometrium and endometrial carcinoma, serum adiponectin, FBG and FINS levels, calculation of stability Insulin resistance index model (HOMA-IR), and then compare the expression of HOMA-IR and serum adiponectin in two groups of patients, the relationship between the serum adiponectin and in endometrial carcinoma. The application of SPSS19.0 for statistical analysis. Results: 1, the serum adiponectin levels in case group (9.13 + 8.79) g/ml was significantly lower than the control group (16.95 + 15.74) g/ml (P0.01); the level of FINS in case group (8.02 + 3.33) U/ml was significantly higher than the control group (6.13 + 2.94) U/ml (P0.01); HOMA-IR in case group (1.74 + 0.97) was significantly higher than the control group (1.29. 0.77) (P0.05; FBG) showed no significant difference in the two groups (.2, P0.05) in non obese patients, serum adiponectin levels in patients with endometrial cancer was significantly lower than the control group (P0.05.3), the results of univariate analysis showed that serum adiponectin, FINS, HOMA-IR for endometrial cancer The factors affecting the adjustment may occur. The risk factors associated with endometrial cancer, low serum adiponectin levels are independent risk factors of the occurrence of endometrial cancer does not depend on insulin resistance (OR=0.869,95%CI:0.807-0.936). And the endometrial cancer risk were.4 dose-response relationship, the serum adiponectin level in different patients endometrial cancer pathological stage, histological grade, histological type, depth of myometrial invasion, cervical involvement, lymph node metastasis, there were no significant differences (P0.05).5, Spearman correlation analysis showed that serum adiponectin levels and HOMA-IR no significant correlation (r=-0.134, P0.05). Conclusion: 1. The serum adiponectin level in patients with endometrial cancer decreased; reduce the non obese patients with endometrial cancer serum adiponectin.2, low serum adiponectin level is the occurrence of endometrial carcinoma The independent risk factors of endometrial cancer risk were.3 dose-response relationship, the serum adiponectin level in endometrial carcinoma with pathological stage, histological grade, pathological type, cervical involvement, lymph node metastasis, depth of myometrial invasion had no correlation with.4, this research has not found a correlation between low serum adiponectin and HOMA-IR in patients with endometrial cancer.

【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.33

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