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

【摘要】：研究背景口腔鱗狀細(xì)胞癌(OSCC)在全球范圍內(nèi)越來越普遍。OSCC的預(yù)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(xué)附屬口腔醫(yī)院收治的口腔鱗狀細(xì)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(xì)胞癌的診斷標(biāo)準(zhǔn)及本研究的納入和排除標(biāo)準(zhǔn)收集病例資料,共計496例,利用SPSS 13.0進(jìn)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(zhì)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(zhì)和脂質(zhì)。基于這些光譜差異和特征,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(jié)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(jié)轉(zhuǎn)移率為42.9%,頸部淋巴結(jié)轉(zhuǎn)移與患者年齡、發(fā)病部位、腫瘤大小與病理分期有關(guān),具有統(tǒng)計學(xué)差異,P0.05。而局部復(fù)發(fā)與腫瘤大小和病理分期有關(guān),具有統(tǒng)計學(xué)差異,P0.05。通過Cox比例風(fēng)險回歸模型分析,結(jié)果明局部復(fù)發(fā)患者的死亡風(fēng)險為無局部復(fù)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(zhì)的分子結(jié)構(gòu)。OSCC組和MEC組對比,不同的峰值歸屬于類胡蘿卜素和脂質(zhì)的特殊分子結(jié)構(gòu)。PCA-LDA分析結(jié)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(jié)果是可靠的。結(jié)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(zhuǎn)移率為42.9%。通過統(tǒng)計分析,口腔鱗癌患者頸部淋巴結(jié)轉(zhuǎn)移與患者性別、發(fā)病部位、腫瘤大小及病理分期相關(guān),而口腔鱗癌患者的局部復(fù)發(fā)則與腫瘤大小及病理分期相關(guān)。影響口腔鱗癌患者預(yù)后的相關(guān)因素為局部復(fù)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(dāng)?shù)奈镔|(zhì)去捕獲高質(zhì)量表面增強拉曼光譜。這項研究的結(jié)果證實,通SERS結(jié)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(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2017
【分類號】：R739.8

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王代友,溫玉明,歐子民,于大海;口腔鱗癌患者化療前后可溶性白介素2受體水平的變化[J];廣西醫(yī)科大學(xué)學(xué)報;2003年02期

2 王代友,歐子民,于大海,巫家曉;口腔鱗癌患者術(shù)后可溶性白介素2受體水平的動態(tài)檢測[J];廣西醫(yī)科大學(xué)學(xué)報;2003年03期

3 王治平,陳偉良,鄭美華,李勁松,楊朝暉;口腔鱗癌患者焦慮、抑郁對療效的影響[J];廣東牙病防治;2004年01期

4 曹陽，陸昌語，張君平;口腔鱗癌患者免疫功能測定及其臨床意義[J];口腔頜面外科雜志;1994年01期

5 李衛(wèi)星,張朝霞,張秀清,甘世新;口腔鱗癌患者血清一氧化氮水平及其手術(shù)前后的變化[J];中國癌癥雜志;2003年01期

6 鄭健,李海如,陳亞明,唐桂紅,胥亞蘭;口腔鱗癌患者血清催乳素水平的變化[J];標(biāo)記免疫分析與臨床;2004年02期

7 李海如,鄭健,陳亞明,唐桂紅,胥亞蘭;口腔鱗癌患者血清催乳素的變化對預(yù)后的影響[J];口腔醫(yī)學(xué);2004年05期

8 鐘來平,陳關(guān)福,許則豐,張行,趙士芳;口腔鱗癌患者唾液中端粒酶活性的表達(dá)[J];華西口腔醫(yī)學(xué)雜志;2005年03期

9 葉冬霞;陳萬濤;周曉健;孫洪;張紅;;口腔鱗癌患者Th1/Th2細(xì)胞亞群漂移的檢測[J];中國口腔頜面外科雜志;2006年02期

10 劉華;余華芳;趙洪偉;;口腔鱗癌患者的全血功能狀態(tài)與腫瘤復(fù)發(fā)風(fēng)險的相關(guān)性研究[J];華西口腔醫(yī)學(xué)雜志;2007年05期

相關(guān)會議論文 前10條

1 楊宏宇;張麗;羅娟;劉冰;李金榮;;手術(shù)前后口腔鱗癌患者外周血淋巴細(xì)胞表型的變化[A];第一屆全國口腔頜面部腫瘤學(xué)術(shù)會議論文匯編[C];2001年

2 鐘來平;陳關(guān)福;平飛云;趙士芳;;口腔鱗癌患者唾液中端粒酶活性的檢測[A];浙江省口腔醫(yī)學(xué)會第二屆會員代表大會暨浙江省第二十三屆口腔醫(yī)學(xué)學(xué)術(shù)會議論文匯編[C];2004年

3 鄒士琦;毛馳;高巖;彭歆;欒修文;俞光巖;;口腔鱗癌患者頸部淋巴結(jié)包膜外擴散的預(yù)后意義[A];第四屆中國腫瘤學(xué)術(shù)大會暨第五屆海峽兩岸腫瘤學(xué)術(shù)會議論文集[C];2006年

4 余東升;余智超;趙琪;;口腔鱗癌患者血清鐵蛋白檢測分析[A];第五次全國口腔頜面—頭頸腫瘤學(xué)術(shù)研討會論文匯編[C];2006年

5 楊凱;李雅東;張福軍;陳睿;張勁松;;新輔助化療對口腔鱗癌患者生存率和生存質(zhì)量的影響研究[A];第五次全國口腔頜面—頭頸腫瘤學(xué)術(shù)研討會論文匯編[C];2006年

6 符義富;;口腔鱗癌患者血清、唾液Cyfra21-1含量檢測的對比研究[A];中華醫(yī)學(xué)會第九次全國檢驗醫(yī)學(xué)學(xué)術(shù)會議暨中國醫(yī)院協(xié)會臨床檢驗管理專業(yè)委員會第六屆全國臨床檢驗實驗室管理學(xué)術(shù)會議論文匯編[C];2011年

7 鐘來平;趙士芳;陳關(guān)福;平飛云;;口腔鱗癌患者血清和唾液CYFRA 21-1的表達(dá)[A];浙江省口腔醫(yī)學(xué)會第二屆會員代表大會暨浙江省第二十三屆口腔醫(yī)學(xué)學(xué)術(shù)會議論文匯編[C];2004年

8 嚴(yán)穎彬;彭歆;毛馳;;FACT-H&N用于口腔鱗癌患者生存質(zhì)量測量的效果評價[A];第八次全國口腔頜面—頭頸腫瘤會議論文匯編[C];2009年

9 蘇樂;沈愛國;胡繼明;;口腔鱗狀細(xì)胞癌組織以及細(xì)胞的拉曼光譜研究[A];第十六屆全國光散射學(xué)術(shù)會議論文摘要集[C];2011年

10 王海燕;王健平;周曾同;;HBD-1和HBD-2在口腔鱗癌患者下頜下腺中的表達(dá)[A];中華口腔醫(yī)學(xué)會第六屆全國口腔黏膜病學(xué)術(shù)會議論文集[C];2004年

相關(guān)博士學(xué)位論文 前2條

1 譚迎峗;基于拉曼光譜技術(shù)的口腔鱗癌患者血清診斷模型研究[D];重慶醫(yī)科大學(xué);2017年

2 鐘來平;口腔鱗癌患者唾液中腫瘤標(biāo)志物的表達(dá)及其機制研究[D];浙江大學(xué);2006年

相關(guān)碩士學(xué)位論文 前10條

1 亞森·祖農(nóng);維吾爾族口腔鱗癌患者中PTEN和CK19的表達(dá)及其臨床意義[D];新疆醫(yī)科大學(xué);2017年

2 王U哢，

本文編號：1938917