Livin、XIAP在子宮內(nèi)膜樣腺癌中的表達(dá)及相關(guān)性研究
發(fā)布時(shí)間：2018-08-03 14:25
【摘要】：目的:子宮內(nèi)膜癌(Endometrial Carcinoma)為女性生殖系統(tǒng)中常見的惡性腫瘤,和宮頸癌、卵巢癌并稱為女性的三大殺手,其中子宮內(nèi)膜樣腺癌是其最常見的組織學(xué)類型。其發(fā)生發(fā)展涉及到細(xì)胞凋亡,是一個(gè)復(fù)雜的過程。凋亡抑制蛋白(IAPs)家族成員XIAP和Livin具有抑制半胱氨酸天冬酶(Caspase),調(diào)控細(xì)胞凋亡以及細(xì)胞分裂、增殖等作用,在惡性腫瘤的發(fā)生發(fā)展過程中表現(xiàn)非常關(guān)鍵。本實(shí)驗(yàn)采取免疫組織化學(xué)的實(shí)驗(yàn)方法,對正常子宮內(nèi)膜組織、子宮內(nèi)膜非典型增生組織以及子宮內(nèi)膜樣腺癌組織中的XIAP和Livin的表達(dá)進(jìn)行檢測,進(jìn)而闡述XIAP和Livin與子宮內(nèi)膜樣腺癌發(fā)生發(fā)展的關(guān)系以及二者之間可能存在的某種關(guān)系,為子宮內(nèi)膜癌的臨床診斷及治療提供理論依據(jù),提高癌癥患者的生存率。方法:本實(shí)驗(yàn)選取河北醫(yī)科大學(xué)第一醫(yī)院2013年10月-2016年3月間手術(shù)切除,并經(jīng)病理證實(shí)的子宮內(nèi)膜樣腺癌標(biāo)本40例、子宮內(nèi)膜非典型增生標(biāo)本40例(診刮標(biāo)本并經(jīng)病理證實(shí)),同時(shí)選取同期因子宮脫垂或子宮肌瘤行子宮切除的正常增生期子宮內(nèi)膜標(biāo)本40例作為對照,采用免疫組織化學(xué)SP法檢測XIAP和Livin在三組標(biāo)本中表達(dá)情況,所得數(shù)據(jù)采用SPSS13.0統(tǒng)計(jì)學(xué)軟件進(jìn)行統(tǒng)計(jì)學(xué)處理,計(jì)數(shù)資料組間的比較以X2檢驗(yàn)進(jìn)行顯著性分析,P0.05視為差異有統(tǒng)計(jì)學(xué)意義。Livin和XIAP表達(dá)的相關(guān)性采用Spearman等級相關(guān)分析。結(jié)果:1 HE染色情況將HE染色切片標(biāo)本置于光學(xué)顯微鏡下,觀察結(jié)果顯示:正常子宮內(nèi)膜腺體的排列整齊,形態(tài)規(guī)則,未見核分裂;子宮內(nèi)膜非典型增生組織可見細(xì)胞存在異型性,內(nèi)膜腺體細(xì)胞極性紊亂且排列不規(guī)則,可見核分裂;子宮內(nèi)膜樣腺癌組織腺體細(xì)胞異型性明顯,排列極度紊亂,核分裂多見。其中,高分化腺癌腺管排列紊亂、擁擠,結(jié)構(gòu)類似增生的腺體,細(xì)胞輕度異型;中分化腺癌的腺體排列不規(guī)則,細(xì)胞異型性明顯,核分裂像易見;低分化腺癌無腺樣結(jié)構(gòu),核異型性明顯,核分裂像多見。2xiap的表達(dá)情況子宮內(nèi)膜樣腺癌組的xiap表達(dá)陽性率為77.5%(31/40);子宮內(nèi)膜非典型增生組的xiap表達(dá)陽性率為70%(28/40);正常子宮內(nèi)膜組的xiap表達(dá)陽性率僅為20%(8/40)。統(tǒng)計(jì)學(xué)分析顯示,子宮內(nèi)膜樣腺癌組及子宮內(nèi)膜非典型增生組中xiap表達(dá)的陽性率顯著高于正常子宮內(nèi)膜組(p0.05),子宮內(nèi)膜樣腺癌組的xiap表達(dá)陽性率較子宮內(nèi)膜非典型增生組有增高趨勢,但差別無統(tǒng)計(jì)學(xué)意義(p0.05)。3livin蛋白的表達(dá)情況子宮內(nèi)膜樣腺癌組的livin表達(dá)陽性率為80%(32/40);子宮內(nèi)膜非典型增生組的livin表達(dá)陽性率為75%(30/40);正常子宮內(nèi)膜組的livin表達(dá)陽性率僅為22.5%(9/40)。統(tǒng)計(jì)學(xué)分析顯示,子宮內(nèi)膜樣腺癌組及子宮內(nèi)膜非典型增生組中l(wèi)ivin表達(dá)的陽性率顯著高于正常子宮內(nèi)膜組(p0.05),子宮內(nèi)膜樣腺癌組的livin表達(dá)陽性率較子宮內(nèi)膜非典型增生組有增高趨勢,但差異無統(tǒng)計(jì)學(xué)意義(p0.05)。4子宮內(nèi)膜樣腺癌組織中的各臨床病理參數(shù)與xiap表達(dá)的關(guān)系在40例子宮內(nèi)膜樣腺癌組織中,xiap的陽性表達(dá)與患者年齡、肌層浸潤深度、淋巴結(jié)的轉(zhuǎn)移與否,差異均無統(tǒng)計(jì)學(xué)意義(p0.05)。在臨床分期中,Ⅰ期的患者xiap的陽性率為55.6%(5/9);Ⅱ期的患者xiap的陽性率為62.5%(5/8);Ⅲ-Ⅳ期的患者xiap的陽性率為91.3%(21/23)。統(tǒng)計(jì)學(xué)分析顯示,xiap的陽性表達(dá)率在各臨床分期中有統(tǒng)計(jì)學(xué)差異(p0.05)。病理分級為g1級的患者xiap的陽性率為55.6%(5/9);g2級的xiap的陽性率為57.1%(4/7);g3級的xiap的陽性率為91.7%(22/24)。統(tǒng)計(jì)學(xué)分析顯示,xiap的陽性表達(dá)率在不同的病理分級中有統(tǒng)計(jì)學(xué)差異(p0.05)。5子宮內(nèi)膜樣腺癌組織中各臨床病理參數(shù)與livin蛋白表達(dá)的關(guān)系在40例子宮內(nèi)膜樣腺癌組織中,livin的陽性表達(dá)與患者年齡、肌層浸潤深度、淋巴結(jié)的轉(zhuǎn)移與否,差異均無統(tǒng)計(jì)學(xué)意義(p0.05)。在臨床分期中,Ⅰ期的患者livin的陽性率為55.6%(5/9);Ⅱ期的患者livin的陽性率為62.5%(5/8);Ⅲ-Ⅳ期的患者livin的陽性率為95.7%(22/23)。統(tǒng)計(jì)學(xué)分析顯示,livin的陽性表達(dá)率在各臨床分期中有統(tǒng)計(jì)學(xué)差異(p0.05)。病理分級為g1級的患者livin的陽性率為55.6%(5/9);g2級的Livin的陽性率為57.1%(4/7);G3級的Livin的陽性率為95.8%(23/24)。統(tǒng)計(jì)學(xué)分析顯示,Livin的陽性表達(dá)率在不同的病理分級中有統(tǒng)計(jì)學(xué)差異(P0.05)。6子宮內(nèi)膜樣腺癌組織中XIAP與Livin的相關(guān)性在XIAP陽性的子宮內(nèi)膜樣腺癌組織中,Livin的陽性率為93.5%(29/31),在XIAP陰性的子宮內(nèi)膜樣腺癌組織中,Livin的陽性率為33.3%(3/9);在Livin陽性的子宮內(nèi)膜樣腺癌組織中,XIAP的陽性率為90.6%(29/32);在Livin陰性的子宮內(nèi)膜樣腺癌組織中,XIAP的陽性率為25.0%(2/8)。統(tǒng)計(jì)學(xué)分析表明,XIAP和Livin在子宮內(nèi)膜樣腺癌中的表達(dá)有相關(guān)性,二者呈正相關(guān)(P0.05)。結(jié)論:1與正常子宮內(nèi)膜比較,子宮內(nèi)膜樣腺癌及子宮內(nèi)膜非典型增生組織中的XIAP和Livin的表達(dá)顯著增多。提示XIAP和Livin的過度表達(dá)可能與子宮內(nèi)膜樣腺癌的發(fā)生有關(guān)。2在子宮內(nèi)膜樣腺癌組織中,XIAP和Livin的陽性表達(dá)率均與年齡、淋巴結(jié)轉(zhuǎn)移及浸潤深度無關(guān),而與臨床分期、病理分級有關(guān),臨床分期和病理分級越高,它們的陽性表達(dá)率越高。提示XIAP和Livin的過度表達(dá)對判斷子宮內(nèi)膜樣腺癌的臨床預(yù)后有一定的意義。3在子宮內(nèi)膜樣腺癌組織中,Livin的陽性表達(dá)與XIAP的陽性表達(dá)呈正相關(guān),二者具有協(xié)同作用。
[Abstract]:Objective: endometrial carcinoma (Endometrial Carcinoma) is a common malignant tumor in the female reproductive system, and cervical cancer, and ovarian cancer is called the three largest killer of women. Endometrioid adenocarcinoma is the most common histologic type. Its development involves apoptosis and is a complex process. The family of apoptosis suppressor protein (IAPs) family Members XIAP and Livin have inhibition of cysteine asparagus (Caspase), regulate cell apoptosis, cell division and proliferation, and play a key role in the development of malignant tumors. This experiment adopts an immunohistochemical method for normal endometrium, endometrium atypical hyperplasia and uterus. The expression of XIAP and Livin in the adenocarcinoma of the membrane was detected, and the relationship between the development of XIAP and Livin and endometrioid adenocarcinoma and the possible relationship between the two were discussed, and the theoretical basis for the clinical diagnosis and treatment of endometrial cancer was provided to improve the survival rate of the cancer patients. Methods: this experiment selected Hebei medicine. 40 cases of endometrioid adenocarcinoma, 40 specimens of endometrium hyperplasia confirmed by pathology, and 40 cases of endometrium adenocarcinoma confirmed by pathology in October 2013 -2016 years, and 40 specimens of endometrium in normal hyperplastic period of hysterectomy or hysteromyoma were selected as control. The immunohistochemical SP method was used to detect the expression of XIAP and Livin in the three groups. The data were statistically treated with SPSS13.0 statistics software, and the comparison between the count data groups was statistically analyzed by X2 test. P0.05 was considered as a difference in the correlation between.Livin and XIAP expression using Spearman grade correlation score. Results: the results of 1 HE staining showed that the specimens of HE stained slices were placed under the optical microscope. The results showed that the normal endometrium glands were arranged orderly, the morphology was regular and no mitosis was found; the atypical hyperplasia tissues of the endometrium showed that the cells were heterotypic, the endometrial glands were very disorderly and irregular in permutation, and the endometrium was visible in the uterus. The glandular cells of the adenocarcinoma of the membrane were characterized by an obvious dysplasia, extremely disorderly arrangement and more mitosis. Among them, the adenocarcinoma of the highly differentiated adenocarcinoma was arranged in disorder, crowded, the structure resembles hyperplasia gland, the cell was mild heteromorphic, the adenocarcinoma in the middle differentiated adenocarcinoma was irregular, the cell heteromorphosis was obvious, and the mitosis was easy to see; the low differentiated adenocarcinoma without adenoid structure and nuclear heteromorphosis The positive rate of XIAP expression in endometrioid adenocarcinoma group was 77.5% (31/40), and the positive rate of XIAP expression in the endometrium atypical hyperplasia group was 70% (28/40), and the positive rate of the normal endometrium group was only 20% (8/40). Statistical analysis showed that endometrioid adenocarcinoma group and endometrium were found in endometrioid adenocarcinoma group and endometrium. The positive rate of XIAP expression in the atypical hyperplasia group was significantly higher than that in the normal endometrium group (P0.05). The positive rate of XIAP expression in endometrioid adenocarcinoma group was higher than that of the endometrium atypical hyperplasia group, but the difference was not statistically significant (P0.05) the expression of.3livin protein in the endometrioid adenocarcinoma group was 80% (32/4). 0) the positive rate of Livin expression in the endometrium atypical hyperplasia group was 75% (30/40), and the positive rate of Livin expression in the normal endometrium group was only 22.5% (9/40). The statistical analysis showed that the positive rate of Livin expression in endometrioid adenocarcinoma group and endometrium atypical hyperplasia group was significantly higher than that of normal endometrium group (P0.05), endometrioid adenocarcinoma. The positive rate of Livin expression in the group was higher than that of the endometrium atypical hyperplasia group, but the difference was not statistically significant (P0.05) the relationship between the clinicopathological parameters and the expression of XIAP in the endometrioid adenocarcinoma of.4 was in 40 endometrioid adenocarcinoma tissues. The positive expression of XIAP was associated with the patient's age, the depth of myometrium infiltration, and the metastasis of lymph nodes. The positive rate of XIAP in stage I was 55.6% (5/9), and the positive rate of XIAP in stage II patients was 62.5% (5/8), and the positive rate of XIAP in stage III - IV patients was 91.3% (21/23). Statistical analysis showed that the positive rate of XIAP was statistically different (P0.05) in the clinical stages (P0.05). The positive rate of XIAP at grade G1 was 55.6% (5/9), the positive rate of XIAP at G2 level was 57.1% (4/7), and the positive rate of XIAP in G3 grade was 91.7% (22/24). Statistical analysis showed that the positive rate of XIAP was statistically different in different pathological grades (P0.05) all the clinicopathological parameters and the protein table in the endometrioid adenocarcinoma tissue of the.5 subuterine. In 40 cases of endometrioid adenocarcinoma, the positive expression of Livin was not statistically significant (P0.05). In clinical stage, the positive rate of Livin in stage I was 55.6% (5/9); the positive rate of Livin in stage II patients was 62.5% (5/8), and liv in stage III - IV patients liv. The positive rate of in was 95.7% (22/23). Statistical analysis showed that the positive rate of Livin was statistically different in each clinical stage (P0.05). The positive rate of Livin in G1 grade patients was 55.6% (5/9); the positive rate of Livin at G2 grade was 57.1% (4/7), and G3 class Livin was 95.8%. The expression rate was statistically different in different pathological grades (P0.05) the correlation between XIAP and Livin in.6 endometrioid adenocarcinoma was in XIAP positive endometrioid adenocarcinoma tissue, the positive rate of Livin was 93.5% (29/31). In XIAP negative endometrioid adenocarcinoma tissue, the positive rate of Livin was 33.3% (3/9), and in Livin positive uterus. In endometrioid adenocarcinoma, the positive rate of XIAP was 90.6% (29/32); in Livin negative endometrioid adenocarcinoma tissue, the positive rate of XIAP was 25% (2/8). Statistical analysis showed that the expression of XIAP and Livin in endometrioid adenocarcinoma was correlated, and the two was positively correlated (P0.05). Conclusion: 1 compared with normal endometrium, endometrioid glands are compared. The expression of XIAP and Livin in the atypical hyperplasia of carcinoma and endometrium increased significantly. It was suggested that the overexpression of XIAP and Livin may be associated with the occurrence of endometrioid adenocarcinoma in endometrioid adenocarcinoma. The positive expression of XIAP and Livin is not related to age, lymph node metastasis and depth of infiltration, but with clinical stage and pathology. The higher the clinical stage and pathological grade, the higher the positive expression rate of XIAP and Livin. It is suggested that the overexpression of XIAP and Livin has a certain significance in judging the clinical prognosis of endometrioid adenocarcinoma. In endometrioid adenocarcinoma tissue, the positive expression of Livin is positively correlated with the positive expression of XIAP, and the two have synergistic effect.
【學(xué)位授予單位】：河北醫(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
本文編號：2162029
[Abstract]:Objective: endometrial carcinoma (Endometrial Carcinoma) is a common malignant tumor in the female reproductive system, and cervical cancer, and ovarian cancer is called the three largest killer of women. Endometrioid adenocarcinoma is the most common histologic type. Its development involves apoptosis and is a complex process. The family of apoptosis suppressor protein (IAPs) family Members XIAP and Livin have inhibition of cysteine asparagus (Caspase), regulate cell apoptosis, cell division and proliferation, and play a key role in the development of malignant tumors. This experiment adopts an immunohistochemical method for normal endometrium, endometrium atypical hyperplasia and uterus. The expression of XIAP and Livin in the adenocarcinoma of the membrane was detected, and the relationship between the development of XIAP and Livin and endometrioid adenocarcinoma and the possible relationship between the two were discussed, and the theoretical basis for the clinical diagnosis and treatment of endometrial cancer was provided to improve the survival rate of the cancer patients. Methods: this experiment selected Hebei medicine. 40 cases of endometrioid adenocarcinoma, 40 specimens of endometrium hyperplasia confirmed by pathology, and 40 cases of endometrium adenocarcinoma confirmed by pathology in October 2013 -2016 years, and 40 specimens of endometrium in normal hyperplastic period of hysterectomy or hysteromyoma were selected as control. The immunohistochemical SP method was used to detect the expression of XIAP and Livin in the three groups. The data were statistically treated with SPSS13.0 statistics software, and the comparison between the count data groups was statistically analyzed by X2 test. P0.05 was considered as a difference in the correlation between.Livin and XIAP expression using Spearman grade correlation score. Results: the results of 1 HE staining showed that the specimens of HE stained slices were placed under the optical microscope. The results showed that the normal endometrium glands were arranged orderly, the morphology was regular and no mitosis was found; the atypical hyperplasia tissues of the endometrium showed that the cells were heterotypic, the endometrial glands were very disorderly and irregular in permutation, and the endometrium was visible in the uterus. The glandular cells of the adenocarcinoma of the membrane were characterized by an obvious dysplasia, extremely disorderly arrangement and more mitosis. Among them, the adenocarcinoma of the highly differentiated adenocarcinoma was arranged in disorder, crowded, the structure resembles hyperplasia gland, the cell was mild heteromorphic, the adenocarcinoma in the middle differentiated adenocarcinoma was irregular, the cell heteromorphosis was obvious, and the mitosis was easy to see; the low differentiated adenocarcinoma without adenoid structure and nuclear heteromorphosis The positive rate of XIAP expression in endometrioid adenocarcinoma group was 77.5% (31/40), and the positive rate of XIAP expression in the endometrium atypical hyperplasia group was 70% (28/40), and the positive rate of the normal endometrium group was only 20% (8/40). Statistical analysis showed that endometrioid adenocarcinoma group and endometrium were found in endometrioid adenocarcinoma group and endometrium. The positive rate of XIAP expression in the atypical hyperplasia group was significantly higher than that in the normal endometrium group (P0.05). The positive rate of XIAP expression in endometrioid adenocarcinoma group was higher than that of the endometrium atypical hyperplasia group, but the difference was not statistically significant (P0.05) the expression of.3livin protein in the endometrioid adenocarcinoma group was 80% (32/4). 0) the positive rate of Livin expression in the endometrium atypical hyperplasia group was 75% (30/40), and the positive rate of Livin expression in the normal endometrium group was only 22.5% (9/40). The statistical analysis showed that the positive rate of Livin expression in endometrioid adenocarcinoma group and endometrium atypical hyperplasia group was significantly higher than that of normal endometrium group (P0.05), endometrioid adenocarcinoma. The positive rate of Livin expression in the group was higher than that of the endometrium atypical hyperplasia group, but the difference was not statistically significant (P0.05) the relationship between the clinicopathological parameters and the expression of XIAP in the endometrioid adenocarcinoma of.4 was in 40 endometrioid adenocarcinoma tissues. The positive expression of XIAP was associated with the patient's age, the depth of myometrium infiltration, and the metastasis of lymph nodes. The positive rate of XIAP in stage I was 55.6% (5/9), and the positive rate of XIAP in stage II patients was 62.5% (5/8), and the positive rate of XIAP in stage III - IV patients was 91.3% (21/23). Statistical analysis showed that the positive rate of XIAP was statistically different (P0.05) in the clinical stages (P0.05). The positive rate of XIAP at grade G1 was 55.6% (5/9), the positive rate of XIAP at G2 level was 57.1% (4/7), and the positive rate of XIAP in G3 grade was 91.7% (22/24). Statistical analysis showed that the positive rate of XIAP was statistically different in different pathological grades (P0.05) all the clinicopathological parameters and the protein table in the endometrioid adenocarcinoma tissue of the.5 subuterine. In 40 cases of endometrioid adenocarcinoma, the positive expression of Livin was not statistically significant (P0.05). In clinical stage, the positive rate of Livin in stage I was 55.6% (5/9); the positive rate of Livin in stage II patients was 62.5% (5/8), and liv in stage III - IV patients liv. The positive rate of in was 95.7% (22/23). Statistical analysis showed that the positive rate of Livin was statistically different in each clinical stage (P0.05). The positive rate of Livin in G1 grade patients was 55.6% (5/9); the positive rate of Livin at G2 grade was 57.1% (4/7), and G3 class Livin was 95.8%. The expression rate was statistically different in different pathological grades (P0.05) the correlation between XIAP and Livin in.6 endometrioid adenocarcinoma was in XIAP positive endometrioid adenocarcinoma tissue, the positive rate of Livin was 93.5% (29/31). In XIAP negative endometrioid adenocarcinoma tissue, the positive rate of Livin was 33.3% (3/9), and in Livin positive uterus. In endometrioid adenocarcinoma, the positive rate of XIAP was 90.6% (29/32); in Livin negative endometrioid adenocarcinoma tissue, the positive rate of XIAP was 25% (2/8). Statistical analysis showed that the expression of XIAP and Livin in endometrioid adenocarcinoma was correlated, and the two was positively correlated (P0.05). Conclusion: 1 compared with normal endometrium, endometrioid glands are compared. The expression of XIAP and Livin in the atypical hyperplasia of carcinoma and endometrium increased significantly. It was suggested that the overexpression of XIAP and Livin may be associated with the occurrence of endometrioid adenocarcinoma in endometrioid adenocarcinoma. The positive expression of XIAP and Livin is not related to age, lymph node metastasis and depth of infiltration, but with clinical stage and pathology. The higher the clinical stage and pathological grade, the higher the positive expression rate of XIAP and Livin. It is suggested that the overexpression of XIAP and Livin has a certain significance in judging the clinical prognosis of endometrioid adenocarcinoma. In endometrioid adenocarcinoma tissue, the positive expression of Livin is positively correlated with the positive expression of XIAP, and the two have synergistic effect.
【學(xué)位授予單位】：河北醫(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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相關(guān)期刊論文 前10條
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相關(guān)碩士學(xué)位論文 前1條
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