本文選題：口腔鱗狀細胞癌 + 表面增強拉曼光譜��； 參考：《重慶醫(yī)科大學》2017年博士論文

【摘要】：研究背景口腔鱗狀細胞癌(OSCC)在全球范圍內越來越普遍。OSCC的預后很大程度上依賴于早期檢測。但常規(guī)口腔檢查可能會延遲診斷,因為在臨床上期口腔惡性病變與早期炎性疾病不易區(qū)分。在這項研究中,收集整理了2013年至2015年間重慶醫(yī)科大學附屬口腔醫(yī)院收治的口腔鱗狀細胞癌患者病例資料并繼續(xù)統(tǒng)計分析,研究了一種新的診斷方法,利用表面增強拉曼光譜(SERS)檢測癌癥患者的血清樣本。方法根據(jù)口腔鱗狀細胞癌的診斷標準及本研究的納入和排除標準收集病例資料,共計496例,利用SPSS 13.0進行統(tǒng)計分析。收集OSCC患者、腮腺粘液表皮樣癌患者和正常對照組志愿者的血清樣本。金納米粒子(NPs)混合血清樣本以獲取高質量的表面增強拉曼光譜。成功地捕捉到135例OSCC光譜樣本、90例粘液表皮樣癌(MEC)樣本和145例正常對照組樣本。與正常對照組相比,OSCC組和MEC組存在拉曼光譜差異,差異歸屬于核酸,蛋白質和脂質�；谶@些光譜差異和特征,主成分分析(PCA)和線性判別分析(LDA)被用來分析和分類各個組的拉曼光譜。結果發(fā)病年齡高峰主要集中在50-59歲、60-69歲及70-79歲三個年齡段之間,男女比例大概為2:1。頸部淋巴結轉移率為42.9%,頸部淋巴結轉移與患者年齡、發(fā)病部位、腫瘤大小與病理分期有關,具有統(tǒng)計學差異,P0.05。而局部復發(fā)與腫瘤大小和病理分期有關,具有統(tǒng)計學差異,P0.05。通過Cox比例風險回歸模型分析,結果明局部復發(fā)患者的死亡風險為無局部復發(fā)患者的約122倍。與正常組相比,OSCC組和MEC組主要增加峰值歸屬于核酸和蛋白質的分子結構。OSCC組和MEC組對比,不同的峰值歸屬于類胡蘿卜素和脂質的特殊分子結構。PCA-LDA分析結果表明OSCC可以成功的與正常對照組辨別,敏感性為80.7%,特異性為84.1%。交叉驗證證明PCA-LDA分析的結果是可靠的。結論重慶地區(qū)口腔鱗癌患者發(fā)病年齡集中,男女比例大概為2:1�？谇击[癌患者頸部淋巴轉移率為42.9%。通過統(tǒng)計分析,口腔鱗癌患者頸部淋巴結轉移與患者性別、發(fā)病部位、腫瘤大小及病理分期相關,而口腔鱗癌患者的局部復發(fā)則與腫瘤大小及病理分期相關。影響口腔鱗癌患者預后的相關因素為局部復發(fā)。對于OSCC、MEC和正常血清樣本來說,金納米粒子(NPs)可以作為適當?shù)奈镔|去捕獲高質量表面增強拉曼光譜。這項研究的結果證實,通SERS結合PCA-LDA分析,對于檢測和診斷OSCC有著巨大的幫助。
[Abstract]:Background: the prognosis of oral squamous cell carcinoma (OSCC) is more and more common in the world. The prognosis of OSCC depends largely on early detection. However, routine oral examination may delay diagnosis because it is not easy to distinguish malignant lesions from early inflammatory diseases. In this study, we collected and analyzed the data of patients with oral squamous cell carcinoma admitted to the affiliated Stomatological Hospital of Chongqing Medical University from 2013 to 2015, and studied a new diagnostic method. Surface enhanced Raman spectroscopy (SERS) was used to detect serum samples from cancer patients. Methods according to the diagnostic criteria of oral squamous cell carcinoma and the inclusion and exclusion criteria of this study, the data of 496 cases were collected and analyzed by SPSS 13.0. Serum samples were collected from OSCC patients, parotid mucoepidermoid carcinoma patients and normal controls. Gold nanoparticles (NPs) mixed with serum samples to obtain high quality surface enhanced Raman spectroscopy. A total of 90 mucoepidermoid carcinoma (OSCC) samples and 145 normal controls were successfully captured. The difference of Raman spectra between OSCC group and MEC group was attributed to nucleic acid, protein and lipid. Based on these spectral differences and characteristics, principal component analysis (PCA) and linear discriminant analysis (LDA) were used to analyze and classify the Raman spectra of different groups. Results the peak age of onset was mainly between 50-59 and 70-79, and the ratio of male and female was about 2: 1. The cervical lymph node metastasis rate was 42.9%. The cervical lymph node metastasis was related to the patient's age, location of disease, tumor size and pathological stage (P 0.05). However, local recurrence was related to tumor size and pathological stage (P 0.05). According to the Cox proportional risk regression model, the risk of death in patients with local recurrence was about 122-fold higher than that in patients without local recurrence. Compared with normal group, OSCC group and MEC group mainly increased the peak value attributed to the molecular structure of nucleic acid and protein. OSCC group and MEC group were compared. Different peaks were attributed to the special molecular structure of carotenoids and lipids. The results of PCA-LDA analysis showed that OSCC could be successfully distinguished from the normal control group with a sensitivity of 80.7 and a specificity of 84.1. Cross-validation proves that the results of PCA-LDA analysis are reliable. Conclusion the age of oral squamous cell carcinoma in Chongqing area is concentrated, and the ratio of male and female is about 2: 1. The cervical lymphatic metastasis rate was 42.9% in patients with oral squamous cell carcinoma. By statistical analysis, cervical lymph node metastasis was correlated with sex, location, tumor size and pathological stage of patients with oral squamous cell carcinoma, while local recurrence of patients with oral squamous cell carcinoma was correlated with tumor size and pathological stage. Local recurrence is associated with prognosis of oral squamous cell carcinoma (OSCC). For OSCC MEC and normal serum samples, gold nanoparticles (NPs) can be used as suitable materials to capture high quality surface-enhanced Raman spectra. The results of this study confirm that SERS combined with PCA-LDA analysis can be of great help in detecting and diagnosing OSCC.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：博士
【學位授予年份】：2017
【分類號】：R739.8

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