發(fā)布時間：2018-05-17 01:34

  本文選題：口腔腫瘤 + 人乳頭狀瘤病毒�。� 參考：《蚌埠醫(yī)學(xué)院》2017年碩士論文

【摘要】：背景:近年來大量研究表明,與HPV陰性相比,HPV陽性口腔腫瘤患者腫瘤進展的風(fēng)險較低,腫瘤生長速度慢、惡化機率低,對放化療治療更為敏感,預(yù)后明顯好于HPV陰性的口腔腫瘤患者,提示人乳頭狀病毒(HPV)在口腔腫瘤的發(fā)生發(fā)展中起重要作用。但目前關(guān)于口腔腫瘤中HPV的感染率,文獻報道的差異很大,對口腔腫瘤與HPV感染相關(guān)性的病因?qū)W探討不多,其具體致病機制尚不清楚。另外,有研究報道,p16抑癌基因的產(chǎn)物p16蛋白的表達與HPV感染密切相關(guān),并有研究者建議可作為HPV的替代檢測手段。皖北地區(qū)是口腔腫瘤的多發(fā)地區(qū)之一,本地區(qū)口腔腫瘤中HPV的感染率如何?p16蛋白在口腔腫瘤組織的表達如何?HPV感染和p16蛋白表達相關(guān)性如何?這些均未見報道,有待闡明。目的:檢測口腔腫瘤組織HPV感染率和p16蛋白表達情況,并探討兩者在口腔腫瘤中的相關(guān)性。方法:收集2014年10月~2015年10月蚌埠醫(yī)學(xué)院第一附屬醫(yī)院口腔科初治的口腔腫瘤患者的腫瘤新鮮組織44例,并記錄患者的年齡、性別、吸煙、飲酒等基本病例情況,同時收集該醫(yī)院口腔部非腫瘤患者組織20例(包括口腔部外傷或鼾癥矯形手術(shù)、炎癥、囊腫)用作對照組。采用PCR法檢測腫瘤組織和非腫瘤組織內(nèi)HPV DNA的表達,了解口腔腫瘤組織中HPV感染情況;應(yīng)用免疫組織化學(xué)染色法檢測腫瘤組織和非腫瘤組織中p16蛋白表達情況;分析HPV感染與p16蛋白表達之間的相關(guān)性及其兩者分別在鑒別口腔腫瘤和非腫瘤中的意義。結(jié)果:口腔腫瘤組織及非腫瘤組織中HPV感染率分別為47.7%(21/44)和10%(2/20)、p16蛋白陽性率分別為77.3%(34/44)和0%(0/20);HPV感染與p16蛋白表達無相關(guān)性(P0.05);口腔腫瘤組織中,與HPV陰性組相比,HPV陽性組男性、非抽煙、非嗜酒者所占比例較高,分別是66.7%vs 66.5%,71.4%vs62.5%,76.2%vs 73.9%,但無統(tǒng)計學(xué)意義(P0.05);與p16蛋白陰性組相比,p16陽性組男性、非抽煙、非嗜酒者所占比例也較高,分別是67.6%vs 60%,94.1%vs 80%,76.4%vs 70%,也無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:皖北地區(qū)口腔腫瘤與HPV感染密切相關(guān);口腔腫瘤組織p16蛋白表達陽性率較高,但與HPV感染無相關(guān)性,p16免疫組化不能作為口腔腫瘤患者HPV感染檢測的替代檢測手段;p16蛋白陽性的口腔腫瘤可能是一個獨立的亞型;HPV感染和p16蛋白表達與性別、吸煙、嗜酒無關(guān)。
[Abstract]:Background: in recent years, a large number of studies have shown that compared with HPV negative, the risk of tumor progression in patients with HPV positive oral tumor is lower, the growth rate of tumor is slow, the probability of deterioration is low, the treatment is more sensitive to radiotherapy and chemotherapy, and the prognosis is better than that of HPV negative oral cancer patients, which suggests that the human breast cancer virus (HPV) plays an important role in the development of oral tumor. But at present, the rate of HPV infection in oral tumor is very different. The etiology of oral tumor and HPV infection is not much, and its specific pathogenesis is not clear. In addition, there are research reports that the expression of p16 protein of the product of p16 suppressor gene is closely related to HPV infection, and some researchers suggest that it can be used as HPV. What is the infection rate of HPV in oral tumor in the local area? How is the expression of p16 protein in oral tumor tissue? How is the correlation between HPV infection and p16 protein expression? These have not been reported and need to be clarified. Objective: to detect the HPV infection rate and the p16 protein table in oral tumor tissue Methods: 44 cases of tumor fresh tissue in oral cancer patients in Department of Stomatology, the First Affiliated Hospital of Bengbu Medical College, October 2014, October ~2015, were collected. The age, sex, smoking, drinking and other basic cases of the patients were recorded, and the non tumor patients in the hospital oral cavity were collected. 20 cases (including oral trauma or snoring orthopedic surgery, inflammation, cysts) were used as control group. The expression of HPV DNA in tumor tissues and non tumor tissues was detected by PCR, and HPV infection in oral tumor tissues was detected. The expression of p16 protein in swelling and non tumor tissues was detected by immunohistochemical staining. The correlation between HPV infection and the expression of p16 protein and the significance of the two were respectively in the identification of oral tumor and non tumor. Results: the infection rate of HPV in oral tumor tissues and non tumor tissues was 47.7% (21/44) and 10% (2/20), and the positive rates of p16 protein were 77.3% (34/44) and 0% (0/20), respectively; HPV infection and p16 protein expression were not correlated (P0.05). In the oral tumor tissue, compared with the HPV negative group, the proportion of non smoking and non alcoholic people in the HPV positive group was higher, which was 66.7%vs 66.5%, 71.4%vs62.5%, 76.2%vs 73.9%, but no statistical significance (P0.05). Compared with the p16 protein negative group, the percentage of non smoking and non alcoholic persons in the p16 positive group was also higher, respectively, 67.6%vs 60%, 94.1, respectively. %vs 80%, 76.4%vs 70%, and no statistical significance (P0.05). Conclusion: the oral tumor in Northern Anhui is closely related to HPV infection; the positive rate of p16 protein expression in oral tumor tissues is high, but it has no correlation with HPV infection. P16 immunohistochemistry can not be used as a substitute for the detection of HPV infection in oral cancer patients; the p16 protein positive oral tumor can be found. It can be an independent subtype; HPV infection and p16 protein expression are not related to sex, smoking and alcohol consumption.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R739.8;R730.43

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