本文選題：YKL-40 + P185�。� 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：背景及目的：卵巢癌（Ovarian canaer，OC）是常見的婦科惡性腫瘤，90％的卵巢癌均為上皮性卵巢癌（Epithelial Ovarian canaer，EOC），其死亡率居于婦科常見三大惡性腫瘤之首，卵巢癌起病較宮頸管癌及子宮內(nèi)膜癌隱匿，部位較深，臨床癥狀、體征不典型并且缺乏有效的早期診斷方法，且易發(fā)生多部位的轉(zhuǎn)移和侵襲，，多數(shù)患者發(fā)現(xiàn)時(shí)已達(dá)晚期，晚期卵巢癌的5年生存率僅為30％左右。而早期卵巢癌的5年生存率達(dá)90％，所以，尋找卵巢癌早期診斷的血清腫瘤標(biāo)記物，對(duì)卵巢癌的早期診斷及時(shí)治療具有重大意義。P185是由癌基因HER-2/neu或e-errbB-2編碼的糖蛋白，癌基因e-errbB-2的擴(kuò)增和（或）過度表達(dá)可導(dǎo)致細(xì)胞生長失控及侵襲性腫瘤細(xì)胞的產(chǎn)生，阻止腫瘤細(xì)胞的凋亡并促進(jìn)其生長。血清中可溶性P185的檢測可用于惡性腫瘤的檢測。YKL-40即人類軟骨蛋白39（Human cartilage glycoprotein-39；HCgp-39），是一種哺乳動(dòng)物殼質(zhì)酶樣蛋白物質(zhì)，在人體組織中參與細(xì)胞的增殖、分化、生長，抗凋亡、侵襲和轉(zhuǎn)移，血管生成、炎性反應(yīng)以及腫瘤細(xì)胞外基質(zhì)的構(gòu)成等多種生命細(xì)胞活動(dòng)。本研究采用酶聯(lián)免疫法及電化學(xué)發(fā)光免疫法對(duì)正常卵巢組織、卵巢良性腫瘤、卵巢癌患者血清YKL-40、P185水平進(jìn)行檢測，并對(duì)二者與卵巢癌臨床分期的關(guān)系進(jìn)行分析，分別探討二者在卵巢癌中的表達(dá)及與卵巢癌發(fā)生、發(fā)展、轉(zhuǎn)移的關(guān)系。進(jìn)一步探討二者聯(lián)合檢測在卵巢癌早期臨床診斷及臨床分期的意義。 方法：收集吉林大學(xué)中日聯(lián)誼醫(yī)院、吉林省腫瘤醫(yī)院2012年1月-2013年10月經(jīng)臨床及術(shù)后病理確診為卵巢癌患者的術(shù)前血液標(biāo)本62例，60例卵巢良性腫瘤及60例體檢健康婦女血液標(biāo)本作為正常對(duì)照組，所有研究對(duì)象均在清晨采集空腹靜脈血3毫升，血液標(biāo)本均采用非抗凝管收集。取血后,常溫下血液凝固至少30分鐘至1小時(shí)。當(dāng)血清自然析出后，在4℃下，2000轉(zhuǎn)/分，離心10分鐘，吸取血清，棄去不溶物。將血清移至一干凈EP管，做好標(biāo)記，-20℃儲(chǔ)藏直至使用。所有血清標(biāo)本避免溶血和反復(fù)凍融。用酶聯(lián)免疫法測定血清中YKL-40、P185水平。數(shù)據(jù)分析應(yīng)用SPSS19.0統(tǒng)計(jì)軟件包進(jìn)行數(shù)據(jù)的統(tǒng)計(jì)分析。 結(jié)果： 1.血清YKL-40、P185在卵巢癌患者中陽性表達(dá)率分別75.81％、80.65％經(jīng)統(tǒng)計(jì)學(xué)分析，卵巢癌患者血清YKL-40、P185水平高于正常卵巢組及卵巢良性腫瘤組，差異具有顯著性（P0.01），而卵巢良性腫瘤和正常對(duì)照組之間無統(tǒng)計(jì)學(xué)意義（P0.05）。 2.血清YKL-40、P185兩項(xiàng)聯(lián)合檢測較單獨(dú)檢測任一項(xiàng)陽性率升高，高達(dá)91.94%，其中對(duì)I期和II期卵巢癌患者檢測的陽性率高達(dá)91.43%，對(duì)III期和IV期卵巢癌患者檢測的陽性率高達(dá)92.59%。 3.聯(lián)合檢測卵巢癌患者血清中YKL-40和P185水平陽性率與卵巢癌臨床分期、病理分型、分化程度無關(guān)。 結(jié)論： 1.血清YKL-40和P185的升高可能提示卵巢癌的發(fā)生、發(fā)展。 2.血清YKL-40、P185兩項(xiàng)聯(lián)合檢測可有效提高卵巢癌早期診斷的敏感度。
[Abstract]:Background and objective: ovarian cancer (Ovarian canaeroc) is a common gynecologic malignant tumor, 90% of which are epithelial ovarian cancer (EOC). The mortality rate of ovarian cancer is the highest among the three most common malignant tumors in gynecology. Ovarian cancer is more occult than cervical canal cancer and endometrial carcinoma. The site is deep, clinical symptoms and signs are not typical, and lack of effective early diagnosis, and prone to multiple sites of metastasis and invasion, most patients have been found by the late stage, the 5-year survival rate of advanced ovarian cancer is only about 30%. The 5-year survival rate of early ovarian cancer is 90%. Therefore, looking for serum tumor markers for early diagnosis of ovarian cancer is of great significance for early diagnosis and treatment of ovarian cancer. P185 is a glycoprotein encoded by the oncogene HER-2pneu or e-errbB-2. The amplification and / or overexpression of oncogene e-errbB-2 can lead to uncontrolled cell growth and the production of invasive tumor cells, which can prevent the apoptosis of tumor cells and promote their growth. The detection of soluble P185 in serum can be used to detect malignant tumor. YKL-40 is human cartilage glycoprotein-39 (HCgp-39), which is a kind of mammalian chitin like protein-like protein, which is involved in cell proliferation, differentiation, growth and anti-apoptosis in human tissues. Invasion and metastasis, angiogenesis, inflammatory response and the formation of tumor extracellular matrix, and so on. In this study, the serum levels of YKL-40 and P185 in normal ovarian tissues, benign ovarian tumors and ovarian cancer patients were detected by enzyme linked immunosorbent assay (Elisa) and electrochemiluminescence immunoassay (ECLIA), and the relationship between the levels of YKL-40 and P185 and the clinical stages of ovarian cancer was analyzed. To investigate the relationship between the expression of Ovarian Cancer and the occurrence, Development and Metastasis of Ovarian Cancer. To explore the significance of combined detection in early clinical diagnosis and clinical staging of ovarian cancer. Methods: the Sino-Japanese Friendship Hospital of Jilin University was collected, From January 2012 to October 2013, 62 patients with ovarian cancer confirmed by clinical and postoperative pathology in Jilin Cancer Hospital, 60 patients with benign ovarian tumor and 60 healthy women as normal control group. All subjects collected 3 ml of fasting venous blood in the early morning. Blood samples were collected by non-anticoagulant tube. After blood collection, blood coagulates at room temperature for at least 30 minutes to 1 hour. When the serum naturally precipitated, it was centrifuged at 4 鈩

本文編號(hào)：2099250