【摘要】：目的： 目前卵巢癌的主要標志物為CA-125，但在卵巢癌早期其敏感性及特異性都不高。如在結(jié)核性胸膜炎、結(jié)核性腹膜炎、腎病綜合征并發(fā)腹水者，其CA-125均可升高。本實驗通過免疫組化方法比較卵巢漿液性囊腺瘤和卵巢漿液性囊腺癌組織中β-微管蛋白及M2型丙酮酸激酶的表達情況，進一步驗證這兩種蛋白在卵巢癌組織中高表達。兩種腫瘤標記物有機結(jié)合，有利于提高卵巢癌早期診斷的敏感性與特異性。 方法： 取吉林大學(xué)第二醫(yī)院2009年8月—2012年11月間的石蠟包埋組織標本，其中卵巢漿液性囊腺癌40例，卵巢漿液性囊腺瘤40例。采用S-P免疫組織化學(xué)法進行染色，，采用Tanaka的定量計分法計算染色結(jié)果。以SPASS17.0統(tǒng)計學(xué)軟件進行分析，P＜0.05提示差異有統(tǒng)計學(xué)意義。 結(jié)果： 1.β-微管蛋白在卵巢漿液性囊腺癌中陽性表達36例，陽性率90%；在卵巢漿液性囊腺瘤組織中陽性表達8例，陽性率20%；這種表達差異是有統(tǒng)計學(xué)意義的(χ2=39.596，P=0.000)。 2.PKM2卵巢漿液性囊腺癌中陽性表達35例，陽性率87.5%；在卵巢漿液性囊腺瘤組織中陽性表達17例，陽性率42.5%；這種表達差異亦有統(tǒng)計學(xué)意義(χ2=17.802，P=0.000)。 3.β-微管蛋白的陽性率在卵巢漿液性囊腺癌組內(nèi)，即I、II、III期中分別為75.0%，83.3%，93.3%，差異無統(tǒng)計學(xué)意義(P0.05)； 4.PKM2的陽性率在卵巢漿液性囊腺癌組內(nèi)，即I、II、III期中分別為75.0%，83.3%，90.0%，差異無統(tǒng)計學(xué)意義(P0.05)； 5.依據(jù)Tanaka的計分法，染色陽性程度可分為3個級別，β-微管蛋白的陽性級別與腫瘤分期無明顯相關(guān)性(P0.05)。 6.依據(jù)Tanaka的計分法，染色陽性程度可分為3個級別，PKM2的陽性級別與腫瘤分期無明顯相關(guān)性(P0.05)。 7.在漿液性卵巢癌組織中，β-微管蛋白與PKM2的陽性率結(jié)果無明顯相關(guān)性。 結(jié)論： 本實驗進一步證明β-微管蛋白、PKM2卵巢漿液性囊腺瘤組織中低表達，在卵巢漿液性囊腺癌組織中高表達，且其在早期卵巢漿液性囊腺癌中的表達與晚期無明顯差異。這為尋求卵巢癌早期診斷新指標提供了新思路。
[Abstract]:Objective: at present, the main marker of ovarian cancer is CA-125, but its sensitivity and specificity are not high in early stage of ovarian cancer. As in tuberculous pleurisy, tuberculous peritonitis, nephrotic syndrome complicated with ascites, their CA-125 can be increased. The expression of 尾 -tubulin and type M2 pyruvate kinase in ovarian serous cystadenoma and ovarian serous cystadenocarcinoma was compared by immunohistochemical method. The combination of two tumor markers can improve the sensitivity and specificity of early diagnosis of ovarian cancer. Methods: paraffin embedded tissue samples were collected from the second Hospital of Jilin University from August 2009 to November 2012. 40 cases of ovarian serous cystadenocarcinoma and 40 cases of ovarian serous cystadenoma were collected. S-P immunohistochemical method was used for staining and Tanaka's quantitative scoring method was used to calculate the staining results. The results were analyzed by SPASS17.0 software, and the difference was statistically significant (P < 0. 05). Results: 1. Positive expression of 尾 -tubulin in ovarian serous cystadenocarcinoma was found in 36 cases (90%), and in ovarian serous cystadenoma in 8 cases (20%). The difference of this expression was statistically significant (蠂 2 / 39.596 P = 0.000). 35 cases (87.5%) were positive in 2.PKM2 ovarian serous cystadenocarcinoma and 17 cases (42.5%) in ovarian serous cystadenoma. 3. The positive rate of 尾 -tubulin in ovarian serous cystadenocarcinoma group was 75.0 and 83.3%, respectively (P0.05). The positive rate of 4.PKM2 in ovarian serous cystadenocarcinoma group was 75.0%, 83.3% and 90.0%, respectively. The difference was not significant (P0.05). According to the Tanaka scoring method, the staining positive degree can be divided into three grades, the positive grade of 尾 -tubulin has no significant correlation with the tumor stage (P0.05). 6. According to the Tanaka scoring method, the staining positive degree can be divided into three grades, the positive grade of PKM2 has no significant correlation with the tumor stage (P0.05). 7. There was no significant correlation between 尾-tubulin and PKM2 positive rate in serous ovarian carcinoma. Conclusion: this study further demonstrated the low expression of 尾-tubulin and PKM2 in ovarian serous cystadenoma, and the high expression of 尾-tubulin in ovarian serous cystadenocarcinoma. There was no significant difference between early ovarian serous cystadenocarcinoma and late stage. This provides a new idea for early diagnosis of ovarian cancer.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.31

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