本文選題：牙齦鱗癌 + 細(xì)胞角蛋白　； 參考：《青島大學(xué)》2014年碩士論文

【摘要】：目的：研究細(xì)胞角蛋白(CK-AE1/AE3)在牙齦鱗狀細(xì)胞癌頸淋巴結(jié)中的表達(dá)及臨床意義。 方法：選取2008年5月到2013年10月間青島大學(xué)附屬醫(yī)院口腔頜面外科病房收治的52例牙齦鱗癌病例,共計(jì)845枚淋巴結(jié)。將845枚淋巴結(jié)根據(jù)常規(guī)HE染色結(jié)果分為病理轉(zhuǎn)移組(pN+,167枚淋巴結(jié))組和病理未轉(zhuǎn)移組(pN0,678枚淋巴結(jié)),其中pN+組根據(jù)陽(yáng)性淋巴結(jié)所在頸部分區(qū)分為陽(yáng)性淋巴結(jié)區(qū)組(A組,28枚陽(yáng)性淋巴結(jié)與44枚陰性淋巴結(jié))和陰性淋巴結(jié)區(qū)組(B組,95枚淋巴結(jié))。將上述各組淋巴結(jié)應(yīng)用廣譜細(xì)胞角蛋白單克隆抗體(CK-AE1/AE3)作為免疫標(biāo)志物,采用SABC法行免疫組織化學(xué)檢測(cè)抗體的表達(dá)。HE染色與CK免疫組化染色兩種檢測(cè)方法結(jié)果應(yīng)用統(tǒng)計(jì)學(xué)軟件SPSS18.0進(jìn)行處理,并按以上結(jié)果將患者重新行TNM分期,結(jié)果行卡方檢驗(yàn)。 結(jié)果：pN+組：A組HE染色陽(yáng)性表現(xiàn)的28枚淋巴結(jié)中,經(jīng)CK免疫組化染色均呈陽(yáng)性表達(dá)；HE染色陰性表現(xiàn)的44枚淋巴結(jié)中,經(jīng)CK免疫組化染色后新發(fā)現(xiàn)5枚淋巴結(jié)呈陽(yáng)性表達(dá),新增陽(yáng)性表達(dá)為11.36%(5/44)。B組HE染色陰性表現(xiàn)的95枚淋巴結(jié)中,經(jīng)CK免疫組化染色后,新發(fā)現(xiàn)6枚淋巴結(jié)呈陽(yáng)性表達(dá),新增陽(yáng)性表達(dá)率為6.31%(6/95)。pN0組：678枚HE染色陰性表現(xiàn)的淋巴結(jié)經(jīng)CK免疫組化染色后,4枚淋巴結(jié)呈陽(yáng)性表達(dá),陽(yáng)性率為0.59%(4/678)。HE染色結(jié)果與CK免疫組織化學(xué)染色結(jié)果經(jīng)統(tǒng)計(jì)學(xué)卡方檢驗(yàn),差異有統(tǒng)計(jì)學(xué)意義(χ2=540.130,p0.01)。CK免疫組化新發(fā)現(xiàn)的15枚陽(yáng)性淋巴結(jié)分別發(fā)生于12例患者中,導(dǎo)致5例患者TNM分期發(fā)生了變化。2例患者的3枚淋巴結(jié)出現(xiàn)“跳躍轉(zhuǎn)移”,其中2枚淋巴結(jié)跳過(guò)Level Ⅰ直接轉(zhuǎn)移至Level Ⅱ,1枚淋巴結(jié)跳過(guò)Level Ⅰ、Level Ⅱ直接轉(zhuǎn)移至Level Ⅲ。跳躍轉(zhuǎn)移淋巴結(jié)均由CK免疫組化染色發(fā)現(xiàn),且均發(fā)生在HE染色陰性(pN0組)的患者。 結(jié)論：采用CK (AE1/AE3)作為免疫標(biāo)志物的免疫組化法檢測(cè)牙齦鱗狀細(xì)胞癌的淋巴結(jié),較傳統(tǒng)HE染色法更為敏感；CK免疫組化檢查可以更準(zhǔn)確的確定TNM分期,從而為牙齦癌的治療及預(yù)后判斷提供依據(jù)；CK免疫組化染色在“跳躍轉(zhuǎn)移”的診斷中具有重要價(jià)值。
[Abstract]:Objective: to study the expression and clinical significance of cytokeratin (CK-AE1 / AE3) in cervical lymph nodes of gingival squamous cell carcinoma (GSCC). Methods: 52 cases of gingival squamous cell carcinoma (GSCC) were selected from the oral and maxillofacial surgery ward of Qingdao University affiliated Hospital from May 2008 to October 2013. A total of 845 lymph nodes were selected. According to the results of routine HE staining, 845 lymph nodes were divided into pathological metastasis group (pN167 lymph nodes) and pathological non-metastatic group (pN0678 lymph nodes). Among them, PN group was divided into positive lymph nodes group (A) according to the cervical division of positive lymph nodes. There were 28 positive and 44 negative lymph nodes and 95 negative lymph nodes in group B. The lymph nodes in the above groups were treated with broad spectrum cytokeratin monoclonal antibody (CK-AE1 / AE3) as immune markers. SABC method was used to detect the expression of antibody. He staining and CK immunohistochemical staining were used to process the results with SPSS 18.0. According to the above results, TNM staging was performed again, and chi-square test was performed. Results out of 28 lymph nodes in group 1: pN, 44 lymph nodes were positive for HE staining by immunohistochemical staining of CK, and 5 lymph nodes were found positive by immunohistochemical staining of CK. The new positive expression was 11.36% (5 / 44). Among 95 lymph nodes with negative HE staining, 6 lymph nodes were found to be positive after CK immunohistochemical staining. The new positive expression rate was 6.31% (6 / 95). PN0 group showed positive expression of 4 lymph nodes in the negative lymph nodes with HE staining. The positive rate was 0.59% (4 / 678). The results of HE staining and immunohistochemical staining of CK were statistically chi-square test. The difference was statistically significant (蠂 ~ 2 ~ 2 ~ (540.130) / p ~ (0.01). The newly discovered 15 positive lymph nodes of CK were found in 12 cases, which resulted in the change of TNM staging in 5 cases and the "jump metastasis" of 3 lymph nodes in 2 cases. Among them, 2 lymph nodes skipped level 鈪，

本文編號(hào)：2061479