發(fā)布時(shí)間：2018-02-12 08:26

  本文關(guān)鍵詞： 宮頸癌 HLA-G 淋巴細(xì)胞計(jì)數(shù) 預(yù)后　出處：《中國(guó)人民解放軍醫(yī)學(xué)院》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：第一部分人類白細(xì)胞抗原G在宮頸癌組織中的表達(dá)與預(yù)后的關(guān)系 目的：探討人類白細(xì)胞抗原G（HLA-G）在宮頸癌組織中的表達(dá)及其對(duì)患者預(yù)后。 方法：應(yīng)用免疫組織化學(xué)方法（S-P法）檢測(cè)2006年1月—2012年12月就診我院98例IB--IIA期宮頸鱗癌組織中HLA-G蛋白的表達(dá)，并分析HLA-G的表達(dá)與臨床病理參數(shù)、患者預(yù)后之間的關(guān)系。 結(jié)果：HLA-G分子在宮頸癌組織中表達(dá)率為43.9%（43/98），而癌旁正常宮頸組織的表達(dá)率為0（0/20）。HLA-G分子表達(dá)與分化程度、淋巴結(jié)轉(zhuǎn)移、脈管浸潤(rùn)具有相關(guān)性（P＜0.05）。HLA-G表達(dá)陽(yáng)性的早期宮頸癌患者無(wú)瘤生存期、總生存期均顯著低于HLA-G陰性患者（P=0.029；P=0.024）。 結(jié)論：HLA-G分子在宮頸癌組織中表達(dá)上調(diào)，，并與宮頸癌的生物學(xué)侵襲行為相關(guān)，促進(jìn)腫瘤的發(fā)生、發(fā)展，影響患者預(yù)后。 第二部分早期宮頸癌患者圍手術(shù)期淋巴細(xì)胞計(jì)數(shù)與預(yù)后之間的關(guān)系 目的：探討早期宮頸癌患者圍手術(shù)期外周血淋巴細(xì)胞計(jì)數(shù)變化與其預(yù)后的關(guān)系。 方法：回顧性分析2006年1月至2012年12年就診于解放軍總醫(yī)院，根據(jù)2009年最新宮頸癌FIGO指南診斷為IB～I(xiàn)IA期宮頸癌患者的臨床病歷資料，分為腹腔鏡組和開(kāi)腹組。比較兩組患者手術(shù)基本情況（手術(shù)時(shí)間、術(shù)中出血量、輸血率、淋巴結(jié)個(gè)數(shù)），分析患者的圍手術(shù)期淋巴細(xì)胞數(shù)和其無(wú)瘤生存期、總生存期間的關(guān)系。 結(jié)果：共222例早期宮頸癌患者納入研究，腹腔鏡組106例，開(kāi)腹組116例。隨訪時(shí)間為6～89個(gè)月，中位隨訪時(shí)間為53個(gè)月。宮頸癌患者術(shù)前淋巴細(xì)胞計(jì)數(shù)增高，其無(wú)瘤生存期、總生存期均顯著延長(zhǎng)；腹腔鏡組術(shù)后第一天淋巴細(xì)胞數(shù)下降程度較開(kāi)腹組明顯減小（P＜0.05），同時(shí)，腹腔鏡組患者術(shù)后第三天淋巴細(xì)胞數(shù)上升也較開(kāi)腹組迅速（P＜0.05）。患者術(shù)后第三天淋巴細(xì)胞計(jì)數(shù)高于或恢復(fù)至術(shù)前水平，無(wú)瘤生存期顯著延長(zhǎng)（P＜0.05）。 結(jié)論：術(shù)前淋巴細(xì)胞數(shù)和術(shù)后第三天淋巴細(xì)胞數(shù)的變化均可作為評(píng)估宮頸癌術(shù)后患者預(yù)后的重要參考指標(biāo)。
[Abstract]:The relationship between the expression of Human Leukocyte Antigen G and prognosis in Cervical carcinoma. Objective: to investigate the expression of human leukocyte antigen GG in cervical carcinoma and its prognostic significance. Methods: the expression of HLA-G protein in 98 cases of cervical squamous cell carcinoma (IB--IIA) from January 2006 to December 2012 was detected by immunohistochemical method. The relationship between the expression of HLA-G and clinicopathological parameters and prognosis was analyzed. Results the expression rate of HLA-G molecule in cervical cancer was 43.9% / 98%, while that in normal cervical tissues adjacent to carcinoma was 0% 20%. The expression and differentiation of HLA-G molecule, lymph node metastasis and vascular infiltration were correlated to the tumor-free survival time of early cervical cancer patients with positive expression of HLA-G (P < 0.05). The total survival time was significantly lower than that in HLA-G negative patients. Conclusion the expression of HLA-G in cervical carcinoma is up-regulated, which is related to the biological invasion behavior of cervical cancer, which promotes the development of tumor and affects the prognosis of cervical cancer. The relationship between perioperative lymphocyte count and prognosis in patients with early cervical cancer. Objective: to investigate the relationship between peripheral blood lymphocyte count and prognosis of early cervical cancer patients. Methods: the clinical data of patients with stage IB~IIA cervical cancer diagnosed by the latest cervical cancer FIGO guidelines of 2009 were retrospectively analyzed in General Hospital of PLA from January 2006 to 2012. The patients were divided into laparoscopy group and laparotomy group. The operation time, intraoperative blood loss, blood transfusion rate and lymph node number were compared between the two groups, and the relationship between the number of lymphocytes in perioperative period and their tumor-free survival time and total survival period were analyzed. Results: a total of 222 patients with early cervical cancer were included in the study. There were 106 cases in the laparoscopic group and 116 cases in the open group. The follow-up time was 6 ~ 89 months and the median follow-up time was 53 months. The total survival time was significantly prolonged in the laparoscopy group, the first day after operation, the decrease of lymphocyte number in the laparoscopy group was significantly lower than that in the open group (P < 0.05), and at the same time, On the third day after operation, the lymphocyte count in the laparoscopic group was also increased more rapidly than that in the open group (P < 0.05), and the lymphocyte count was higher or returned to the preoperative level on the third day after operation, and the tumor-free survival time was significantly prolonged (P < 0.05). Conclusion: the change of lymphocyte number before operation and on the third day after operation can be used as an important index to evaluate the prognosis of patients with cervical cancer after operation.
【學(xué)位授予單位】：中國(guó)人民解放軍醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.33

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 賀新婷;;奇怪的遺囑和“不完整”的蒂皮特[J];歌劇;2008年01期

本文編號(hào)：1505201