本文選題：漿液性卵巢癌 + 免疫組化　； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:分析卵巢漿液性癌中ER、PR、WT-1、Ki-67、CA125的表達(dá)情況,分析新輔助化療是否對(duì)卵巢癌組織中此類蛋白的表達(dá)產(chǎn)生影響;ER、PR、WT-1、Ki-67、CA125與發(fā)病年齡、是否絕經(jīng)、腫瘤的分型、病理分期、淋巴轉(zhuǎn)移、腹水、殘余腫瘤體積等情況進(jìn)行比較,為卵巢漿液性癌的臨床診斷、預(yù)后分析及激素治療提供參考。方法:篩選2014年1月至2015年12月在吉林大學(xué)第一醫(yī)院婦產(chǎn)科初治的卵巢漿液性癌患者82例,收集患者的病理學(xué)參數(shù)(年齡、臨床分期、組織分化、組織類型等),根據(jù)我院病理科醫(yī)生所檢測(cè)的ER、PR、WT-1、Ki-67、CA125的結(jié)果,分析其中相關(guān)關(guān)系。采用SPSS 21.0統(tǒng)計(jì)學(xué)軟件對(duì)數(shù)據(jù)進(jìn)行處理,用χ2檢驗(yàn)、Fisher確切概率分析法對(duì)數(shù)據(jù)進(jìn)行率的檢驗(yàn),相關(guān)性檢驗(yàn)采用Spearman等級(jí)相關(guān)檢驗(yàn)進(jìn)行分析,檢驗(yàn)水準(zhǔn)p0.05為無(wú)統(tǒng)計(jì)學(xué)差異,p0.05有統(tǒng)計(jì)學(xué)意義,p0.01為統(tǒng)計(jì)學(xué)差異非常顯著。結(jié)果:1、卵巢漿液性癌中,ER、PR、WT-1、Ki-67、CA125均有表達(dá),其表達(dá)率分別為:76.83%、47.56%、85.37%、90.24%和90.24%。2、ER表達(dá)情況與FIGO分期、有無(wú)腹水之間存在顯著差異(p0.05),且在Ⅲ、Ⅳ期卵巢漿液性癌中的表達(dá)明顯高于I、II期,有腹水組高于無(wú)腹水組。3、PR的表達(dá)在是否絕經(jīng)組存在差異(P0.05),其余組p值均0.05,在絕經(jīng)組PR表達(dá)明顯高于非絕經(jīng)組。4、WT-1表達(dá)情況在各組臨床病理指標(biāo)間,除FIGO分期(p0.05)外均無(wú)顯著性差異,WT-1的表達(dá)率在Ⅲ、Ⅳ組明顯多于I、II期組。5、Ki-67的表達(dá)在組織分化組、FIGO分期組存在差異(p0.05),其中高級(jí)別組明顯多于低級(jí)別組,Ⅲ、Ⅳ期卵巢漿液性癌明顯多于I、II期。6、CA125的表達(dá)在FIGO分期組、有無(wú)腹水組和病灶殘留組有顯著性差異(p0.05),Ⅲ、Ⅳ期卵巢漿液性癌明顯多于I、II期,有腹水組高于無(wú)腹水組,病灶殘留≥1cm組多余病灶1cm組。7、ER、PR、WT-1、Ki-67、CA125之間,ER與PR、ER與WT-1、WT-1與CA125、Ki-67與CA125之間有相關(guān)性(p0.05),且均為正相關(guān),其他各因素間不具有相關(guān)性。結(jié)論:1、卵巢漿液性癌中,ER、PR、WT-1、Ki-67、CA125均有表達(dá),其表達(dá)率分別為:76.83%、47.56%、85.37%、90.24%和90.24%,為卵巢漿液性癌的靶向治療及內(nèi)分泌治療提供理論依據(jù)。2、WT-1在晚期的卵巢漿液性癌患者中多呈陽(yáng)性表達(dá),且與臨床分期之間密切相關(guān),這可能因?yàn)閃T-1在腫瘤細(xì)胞起著激活作用,為卵巢癌的靶向基因治療提供依據(jù)。3、Ki-67在卵巢漿液性癌中,與組織分化組、FIGO分期組存在顯著差異,CA125在FIGO分期組、有無(wú)腹水組和病灶殘留組間有顯著性差異,本文雖未行生存期相關(guān)檢查,但根據(jù)上述病理學(xué)參數(shù)與生存期關(guān)系可知,二者高表達(dá)時(shí)可能提示預(yù)后不良。4、ER的表達(dá)與FIGO分期、有無(wú)腹水之間存在顯著差異,PR在是否絕經(jīng)組間存在差異,ER、PR之間存在正相關(guān),提示二者可能共同作用于卵巢漿液性癌,為后續(xù)卵巢癌患者的內(nèi)分泌治療提供參考。5、ER與WT-1的表達(dá)之間存在正相關(guān),可能共同參與了卵巢癌的發(fā)生發(fā)展過(guò)程,但是其間作用機(jī)制還需要后續(xù)研究進(jìn)一步明確。6、CA125與WT-1、CA125與Ki-67的表達(dá)之間具有相關(guān)性,且為正相關(guān),所以在卵巢癌的判定過(guò)程中聯(lián)合CA125、WT-1和Ki-67可能提高檢測(cè)的準(zhǔn)確性。
[Abstract]:Objective: to analyze the expression of ER, PR, WT-1, Ki-67 and CA125 in ovarian serous carcinoma, and to analyze the effect of neoadjuvant chemotherapy on the expression of such proteins in ovarian cancer; ER, PR, WT-1, Ki-67, CA125 and age, menopause, pathological stage, lymphatic metastasis, ascites, and residual tumor volume, are compared. The clinical diagnosis, prognosis analysis and hormone therapy of ovarian serous carcinoma provide reference. Methods: 82 cases of ovarian serous cancer were selected from January 2014 to December 2015 in No.1 Hospital of Jilin University of gynecology and obstetrics, and collected the pathological parameters of the patients (age, clinical stage, group differentiation, tissue type, etc.), according to the doctor of pathology of our hospital. The results of ER, PR, WT-1, Ki-67, CA125 were detected. The data were processed by SPSS 21 statistical software, the data rate was tested by the x 2 test, the exact probability analysis of Fisher was tested, the correlation test was analyzed with Spearman grade correlation test, and the test level P0.05 was not statistically different, and P0.05 had statistics. The significance of P0.01 was statistically significant. Results: 1, in ovarian serous carcinoma, ER, PR, WT-1, Ki-67, CA125 were expressed, and their expression rates were 76.83%, 47.56%, 85.37%, 90.24% and 90.24%.2 respectively. There was a significant difference between the expression of ER and the stage of FIGO (P0.05), and the expression of the ovarian serous carcinoma in stage III and IV was obviously expressed. Higher than I, II, and ascites group was higher than no ascites group.3, the expression of PR in the menopause group was different (P0.05), the other group P value was 0.05, the expression of PR in the menopause group was significantly higher than the non menopause.4, the WT-1 expression in each group of clinicopathological indexes, except FIGO stages (P0.05), there were no significant differences, WT-1 expression rate in the third, group IV obviously more than those in the group. The expression of.5 and Ki-67 in the II group was in the tissue differentiation group and the FIGO staging group was different (P0.05). The advanced group was obviously more than the low grade group. The ovarian serous carcinoma in stage III and IV was obviously more than I, II stage.6 and CA125 expressed in the FIGO staging group. There was significant difference between the ascites group and the residual focus group (P0.05), and the ovarian serous carcinoma in stage III and IV was significantly more. At I and II, the group of ascites was higher than that in the non ascites group, and the residual lesion of the lesion was more than 1cm in group 1cm.7, ER, PR, WT-1, CA125, ER and PR. The expression rate is 76.83%, 47.56%, 85.37%, 90.24% and 90.24%, which provide a theoretical basis for the targeting and endocrine therapy of ovarian serous carcinoma,.2. WT-1 is mostly positive in patients with advanced ovarian serous carcinoma and is closely related to clinical stages, which may be due to the activation of WT-1 in the tumor cells. The target gene therapy of nested carcinoma provides a basis for.3, and there is a significant difference between Ki-67 in ovarian serous carcinoma, tissue differentiation group and FIGO staging group. There are significant differences between CA125 in FIGO staging group, and there is a significant difference between the group of ascites and the residual focus group. This article has not checked the survival time, but the two groups are based on the relationship between the above pathological parameters and the survival time. High expression may indicate poor prognosis.4, ER expression and FIGO staging, there is a significant difference between ascites and non ascites. There is a difference between PR in the menopause group and there is a positive correlation between ER and PR, suggesting that the two may work together in the ovarian serous carcinoma, providing a reference.5 for the endocrine therapy of the subsequent ovarian cancer patients, and between the expression of ER and WT-1. There is a positive correlation, which may be involved in the development of ovarian cancer, but the mechanism of action also needs further research to further clarify.6, CA125 and WT-1, and the correlation between CA125 and Ki-67, and it is positive correlation, so the combination of CA125, WT-1 and Ki-67 in the determination of ovarian cancer may improve the accuracy of the detection.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.31

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