SPAG9在宮頸腺癌中的表達及其臨床意義
發(fā)布時間：2018-09-07 11:39
【摘要】：背景宮頸癌是最為常見的婦科惡性腫瘤之一,極大的威脅著廣大女性的身體健康。近50年來,由于社會生活改變和人乳頭狀瘤病毒(HPV)感染人數(shù)增多,宮頸腺癌的發(fā)病有增加的趨勢,且患者年輕化現(xiàn)象明顯。宮頸腺癌、鱗癌這兩種不同的病理類型在病因和發(fā)病機制上存在差別。宮頸原發(fā)腺癌由于病灶起源于宮頸管內(nèi),早期病灶隱匿,為宮頸局部的硬結(jié),宮頸外觀可無明顯異常,多無癥狀,婦科檢查常不被發(fā)現(xiàn)。宮頸癌的目前篩檢方法主要為宮頸薄層液基細胞學(xué)。但由于宮頸腺癌病灶隱匿,因此細胞學(xué)檢查陰性率高,容易造成漏診。原發(fā)于宮頸的腺癌易與原發(fā)于子宮內(nèi)膜的腺癌混淆,尤其是宮頸和子宮內(nèi)膜均有病灶時,兩者的診治方法有很大的差別。宮頸腺癌的手術(shù)治療創(chuàng)傷大、放化療治療副反應(yīng)高,且與宮頸鱗癌相比預(yù)后差,因此宮頸腺癌的早期診治、鑒別診斷和預(yù)后評估具有重要意義。目前,尚缺乏一種有效的分子生物學(xué)標(biāo)記物可以有效協(xié)助宮頸腺癌的早期診斷、鑒別診斷、預(yù)后評估和靶向治療。宮頸腺癌發(fā)病率低,關(guān)于它的研究少,因此探究一種新的有效的可以協(xié)助宮頸腺癌的早期診斷、鑒別診斷、預(yù)后評估的分子生物學(xué)標(biāo)記物成為研究熱點,也有助于探究宮頸腺癌的發(fā)病機制,并能夠提供科學(xué)依據(jù)利于宮頸腺癌的分子靶向治療的發(fā)展。 目的研究宮頸腺癌組織中精子相關(guān)抗原-9(SPAG9)的表達及SPAG9在宮頸腺癌早期診斷、鑒別診斷、預(yù)后評估等方面的潛在臨床應(yīng)用價值,為宮頸腺癌的分子靶向治療提供科學(xué)依據(jù)。 方法研究對象自2007年1月起至2013年5月,在山東省立醫(yī)院婦科就診的50例宮頸腺癌患者和與之同期的年齡相匹配的50例宮頸無任何病變的的因子宮平滑肌瘤、子宮腺肌病等良性疾病行子宮全切術(shù)的患者。實驗方法應(yīng)用免疫組化SABC法,檢測50例宮頸腺癌和50例正常宮頸組織中SPAG9蛋白的表達。 結(jié)果1.臨床資料分析該項研究中腫瘤組病例的平均初產(chǎn)年齡與正常宮頸組患者的平均初產(chǎn)年齡無顯著性差異,腫瘤組初產(chǎn)年齡小于21歲的患者數(shù)目小于正常宮頸組,但兩者差別沒有統(tǒng)計學(xué)意義(P0.05)。腫瘤組孕次≥4次的患者數(shù)目大于正常宮頸組,但兩者差別沒有統(tǒng)計學(xué)意義(P0.05)。在這50例宮頸腺癌患者的調(diào)查中,宮頸腺癌的發(fā)病與孕次、初產(chǎn)年齡無關(guān),不能支持宮頸腺癌的發(fā)病危險因素與多產(chǎn)等相關(guān)的觀點。 2.染色結(jié)果本研究通過免疫組化的方法檢測至SPAG9在正常宮頸組織中不表達(0%,0/18),在宮頸腺癌組織中高表達(100%,50/50), SPAG9蛋白主要表達于宮頸腺癌癌細胞的胞漿內(nèi),腺體周圍的間質(zhì)組織則很少表達,并且隨著臨床分期、病理分級,淋巴結(jié)轉(zhuǎn)移的增加SPAG9蛋白表達逐漸增高,且在腫瘤病理分級中這種趨勢有統(tǒng)計學(xué)意義(P0.05)。說明SPAG9在宮頸腺癌中的表達與腫瘤病理分級有相關(guān)性,與腫瘤分期和淋巴結(jié)轉(zhuǎn)移無關(guān)。表明SPAG9存在于宮頸腺癌中,可能在宮頸腺癌的發(fā)生發(fā)展中發(fā)揮重要的作用。 3.不同預(yù)后的宮頸腺癌患者SPAG9染色H-score分析無論是所有的隨訪病例,隨訪滿一年的病例、隨訪滿兩年病例、隨訪滿三年病例還是隨訪滿四年的病例,死亡病例的H-score分值均大于存活病例的H-score的分值。這既說明了在死亡病例中SPAG9蛋白的表達大于存活病例中SPAG9的表達,SPAG9可能促進了疾病的發(fā)生、進展,增加了疾病的惡性潛能,也說明了SPAG9表達水平的檢測對于宮頸腺癌患者的預(yù)后預(yù)測具有重要意義。 4.不同病理類型對應(yīng)的SPAG9染色結(jié)果由染色結(jié)果可以看出不同病理類型SPAG9表達量存在差異,但由于本次研究病例數(shù)目少,無法比較不同病理類型間SPAG9表達的差異性是否具有統(tǒng)計學(xué)意義。將SPAG9作為輔助診斷宮頸腺癌病理類型的標(biāo)記分子仍有待進一步研究。 5.口服避孕藥對SPAG9表達的影響討論發(fā)病前長期吃避孕藥的患者SPAG9H-score評分高于未應(yīng)用避孕藥避孕的患者,但差別無統(tǒng)計學(xué)意義(P0.05)。 結(jié)論通過此次研究,我們發(fā)現(xiàn)SPAG9在宮頸腺癌中表達,在正常宮頸組織中不表達,且SPAG9的表達與腫瘤病理分級有相關(guān)性,與腫瘤分期和淋巴結(jié)轉(zhuǎn)移無關(guān)。死亡病例中SPAG9H-score的分值均大于存活病例的H-score的分值。本次研究結(jié)果提示宮頸腺癌組與正常宮頸組在初產(chǎn)年齡、孕次無明顯差異,不能支持多產(chǎn)等是宮頸腺癌發(fā)病危險因子的觀點。由于病例數(shù)目少,口服避孕藥患者數(shù)量很少,避孕藥與SPAG9表達間的關(guān)系仍有待進一步研究考證。相同的原因,SPAG9作為輔助診斷宮頸腺癌病理類型的標(biāo)記分子仍有待進一步研究。通過本次研究,我們可以看出SPAG9可能與宮頸腺癌的發(fā)生和發(fā)展有關(guān),它在宮頸腺癌患者預(yù)后判斷方面具有重要意義,具有成為作為宮頸腺癌早期診斷和預(yù)后評估和靶向治療的生物學(xué)標(biāo)記物的可能。
[Abstract]:Background Cervical cancer is one of the most common gynecological malignancies, which is a great threat to the health of women. In the past 50 years, the incidence of cervical adenocarcinoma has been increasing due to the change of social life and the increase of the number of HPV infection, and the phenomenon of younger patients is obvious. Cervical adenocarcinoma and squamous cell carcinoma are two different diseases. Cervical primary adenocarcinoma originates in the cervical canal and is occult in the early stage. It is a local induration of the cervix. The appearance of the cervix is not obvious abnormality and most of the symptoms are asymptomatic. Gynecological examination is often not found. Current screening methods for cervical cancer are mainly thin-layer liquid-based cytology of the cervix. Adenocarcinoma of the cervix is easily confused with adenocarcinoma of the endometrium, especially when both the cervix and the endometrium have lesions. The surgical treatment of cervical adenocarcinoma is traumatic, the side effects of radiotherapy and chemotherapy are high, and it is also different from that of the uterus. Cervical squamous cell carcinoma has a poor prognosis, so early diagnosis, differential diagnosis and prognostic evaluation of cervical adenocarcinoma are of great significance. At present, there is still a lack of an effective molecular biomarker that can effectively assist the early diagnosis, differential diagnosis, prognostic evaluation and targeted treatment of cervical adenocarcinoma. To explore a new and effective molecular biomarker for early diagnosis, differential diagnosis and prognosis evaluation of cervical adenocarcinoma has become a hot research topic. It can also help to explore the pathogenesis of cervical adenocarcinoma and provide scientific basis for the development of molecular targeted therapy of cervical adenocarcinoma.
Objective To study the expression of sperm-associated antigen-9 (SPAG9) in cervical adenocarcinoma and its potential clinical value in early diagnosis, differential diagnosis and prognosis evaluation of cervical adenocarcinoma.
Methods From January 2007 to May 2013, 50 patients with cervical adenocarcinoma and 50 patients with benign diseases such as uterine leiomyoma and adenomyosis without any cervical lesions were examined by immunohistochemical SABC. The expression of SPAG9 protein was detected in 50 cases of cervical adenocarcinoma and 50 cases of normal cervical tissue.
Results 1. There was no significant difference in the average age of primipara between the cancer group and the normal cervical group. The number of patients whose age of primipara was less than 21 years old in the cancer group was smaller than that in the normal cervical group, but there was no significant difference between the two groups (P 0.05). The number of patients with more than 4 pregnancies in the cancer group was larger than that in the normal cervical group. In the 50 cases of cervical adenocarcinoma, the incidence of cervical adenocarcinoma was not related to pregnancy and the age of first birth, and could not support the view that the risk factors of cervical adenocarcinoma were related to prolificacy.
2. The staining results showed that SPAG9 was not expressed in normal cervical tissues (0%, 0/18), was highly expressed in cervical adenocarcinoma tissues (100%, 50/50), SPAG9 was mainly expressed in the cytoplasm of cervical adenocarcinoma cells, but seldom expressed in the interstitial tissues around the gland, and with the clinical stage, pathological grade, gonorrhea. The expression of SPAG9 protein in cervical adenocarcinoma was correlated with the pathological grade of cervical adenocarcinoma, but not with the tumor stage and lymph node metastasis. The exhibition plays an important role.
3. SPAG9 staining H-score analysis of cervical adenocarcinoma patients with different prognosis showed that H-score of death cases was higher than H-score of survival cases in all follow-up cases, follow-up cases for more than one year, follow-up cases for more than two years, follow-up cases for more than three years or follow-up cases for more than four years. The expression of SPAG9 in white cells was higher than that in survivors. SPAG9 may promote the occurrence and progression of the disease and increase the malignant potential of the disease.
4. Different pathological types of SPAG9 staining results can be seen from the staining results of different pathological types of SPAG9 expression differences, but because the number of cases in this study is small, it is impossible to compare the different pathological types of SPAG9 expression is statistically significant. Molecular remains to be further studied.
5. The effect of oral contraceptives on the expression of SPAG9.
Conclusion Through this study, we found that SPAG9 was expressed in cervical adenocarcinoma, but not in normal cervical tissues, and the expression of SPAG9 was correlated with the pathological grade of cervical cancer, not with tumor stage and lymph node metastasis. The relationship between the expression of SPAG9 and the number of oral contraceptives remains to be further studied because of the small number of cases and the small number of oral contraceptives. Through this study, we can see that SPAG9 may be related to the occurrence and development of cervical adenocarcinoma. It is of great significance in the prognosis of patients with cervical adenocarcinoma and can be used as a biomarker for early diagnosis and prognosis evaluation and targeted therapy of cervical adenocarcinoma. It's possible.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.33
本文編號：2228157
[Abstract]:Background Cervical cancer is one of the most common gynecological malignancies, which is a great threat to the health of women. In the past 50 years, the incidence of cervical adenocarcinoma has been increasing due to the change of social life and the increase of the number of HPV infection, and the phenomenon of younger patients is obvious. Cervical adenocarcinoma and squamous cell carcinoma are two different diseases. Cervical primary adenocarcinoma originates in the cervical canal and is occult in the early stage. It is a local induration of the cervix. The appearance of the cervix is not obvious abnormality and most of the symptoms are asymptomatic. Gynecological examination is often not found. Current screening methods for cervical cancer are mainly thin-layer liquid-based cytology of the cervix. Adenocarcinoma of the cervix is easily confused with adenocarcinoma of the endometrium, especially when both the cervix and the endometrium have lesions. The surgical treatment of cervical adenocarcinoma is traumatic, the side effects of radiotherapy and chemotherapy are high, and it is also different from that of the uterus. Cervical squamous cell carcinoma has a poor prognosis, so early diagnosis, differential diagnosis and prognostic evaluation of cervical adenocarcinoma are of great significance. At present, there is still a lack of an effective molecular biomarker that can effectively assist the early diagnosis, differential diagnosis, prognostic evaluation and targeted treatment of cervical adenocarcinoma. To explore a new and effective molecular biomarker for early diagnosis, differential diagnosis and prognosis evaluation of cervical adenocarcinoma has become a hot research topic. It can also help to explore the pathogenesis of cervical adenocarcinoma and provide scientific basis for the development of molecular targeted therapy of cervical adenocarcinoma.
Objective To study the expression of sperm-associated antigen-9 (SPAG9) in cervical adenocarcinoma and its potential clinical value in early diagnosis, differential diagnosis and prognosis evaluation of cervical adenocarcinoma.
Methods From January 2007 to May 2013, 50 patients with cervical adenocarcinoma and 50 patients with benign diseases such as uterine leiomyoma and adenomyosis without any cervical lesions were examined by immunohistochemical SABC. The expression of SPAG9 protein was detected in 50 cases of cervical adenocarcinoma and 50 cases of normal cervical tissue.
Results 1. There was no significant difference in the average age of primipara between the cancer group and the normal cervical group. The number of patients whose age of primipara was less than 21 years old in the cancer group was smaller than that in the normal cervical group, but there was no significant difference between the two groups (P 0.05). The number of patients with more than 4 pregnancies in the cancer group was larger than that in the normal cervical group. In the 50 cases of cervical adenocarcinoma, the incidence of cervical adenocarcinoma was not related to pregnancy and the age of first birth, and could not support the view that the risk factors of cervical adenocarcinoma were related to prolificacy.
2. The staining results showed that SPAG9 was not expressed in normal cervical tissues (0%, 0/18), was highly expressed in cervical adenocarcinoma tissues (100%, 50/50), SPAG9 was mainly expressed in the cytoplasm of cervical adenocarcinoma cells, but seldom expressed in the interstitial tissues around the gland, and with the clinical stage, pathological grade, gonorrhea. The expression of SPAG9 protein in cervical adenocarcinoma was correlated with the pathological grade of cervical adenocarcinoma, but not with the tumor stage and lymph node metastasis. The exhibition plays an important role.
3. SPAG9 staining H-score analysis of cervical adenocarcinoma patients with different prognosis showed that H-score of death cases was higher than H-score of survival cases in all follow-up cases, follow-up cases for more than one year, follow-up cases for more than two years, follow-up cases for more than three years or follow-up cases for more than four years. The expression of SPAG9 in white cells was higher than that in survivors. SPAG9 may promote the occurrence and progression of the disease and increase the malignant potential of the disease.
4. Different pathological types of SPAG9 staining results can be seen from the staining results of different pathological types of SPAG9 expression differences, but because the number of cases in this study is small, it is impossible to compare the different pathological types of SPAG9 expression is statistically significant. Molecular remains to be further studied.
5. The effect of oral contraceptives on the expression of SPAG9.
Conclusion Through this study, we found that SPAG9 was expressed in cervical adenocarcinoma, but not in normal cervical tissues, and the expression of SPAG9 was correlated with the pathological grade of cervical cancer, not with tumor stage and lymph node metastasis. The relationship between the expression of SPAG9 and the number of oral contraceptives remains to be further studied because of the small number of cases and the small number of oral contraceptives. Through this study, we can see that SPAG9 may be related to the occurrence and development of cervical adenocarcinoma. It is of great significance in the prognosis of patients with cervical adenocarcinoma and can be used as a biomarker for early diagnosis and prognosis evaluation and targeted therapy of cervical adenocarcinoma. It's possible.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.33
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