發(fā)布時(shí)間：2018-07-02 08:44

  本文選題：中介體復(fù)合物19 + 舌癌　； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:口腔頜面部的惡性腫瘤多屬于鱗狀細(xì)胞癌,其發(fā)病占頜面部惡性腫瘤的80%以上,而舌體是其高發(fā)部位。在我國(guó)多見于成年男性患者,早期常有淋巴結(jié)轉(zhuǎn)移,晚期可向遠(yuǎn)處轉(zhuǎn)移。目前沒有特異性強(qiáng)的舌癌診斷指標(biāo)。研究表明,在多種人類腫瘤中都能夠發(fā)現(xiàn)MED19的高表達(dá),并且在體外實(shí)驗(yàn)發(fā)現(xiàn)抑制MED19能夠引起相應(yīng)腫瘤細(xì)胞系的生長(zhǎng)抑制和凋亡增加。本實(shí)驗(yàn)探討MED19在舌癌中的表達(dá),研究其與患者的臨床特征的相關(guān)性,并與患者預(yù)后生存率進(jìn)行相關(guān)分析。方法:收集2012年1月至2016年9月,青島大學(xué)附屬煙臺(tái)毓璜頂醫(yī)院病理科舌癌標(biāo)本蠟塊50例,全部患者均臨床資料完整,無(wú)其他惡性腫瘤并發(fā)且術(shù)前無(wú)放化療史。另外選擇50例癌旁組織和20例正常組織作為對(duì)照組。癌旁組織取自距癌組織1cm處。于距離癌組織大于1cm處取癌旁組織。整理了2012年1月至2014年6月,青島大學(xué)附屬煙臺(tái)毓璜頂醫(yī)院口腔頜面外科24例舌癌患者。通過(guò)復(fù)查或電話隨訪獲取資料。應(yīng)用單因素和多因素COX回歸分析MED19與患者預(yù)后的相關(guān)性,通過(guò)Kaplan-Meier分析MED19與患者生存率的關(guān)系。結(jié)果:免疫組化實(shí)驗(yàn)顯示,MED19在舌癌細(xì)胞的細(xì)胞核與細(xì)胞漿中都有高表達(dá),染色棕黃。MED19在50例TSCC組織中有29例表達(dá),陽(yáng)性率為58%,MED19在癌旁表達(dá)率較低,50例癌旁僅有11例表達(dá),陽(yáng)性率為22%,在20例正�？谇唤M織中有4例表達(dá),陽(yáng)性率為20%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。MED19蛋白在有淋巴結(jié)轉(zhuǎn)移組的陽(yáng)性表達(dá)率為88.2%,在無(wú)淋巴結(jié)轉(zhuǎn)移組的陽(yáng)性率為42.4%,差異明顯,且具有統(tǒng)計(jì)學(xué)意義(P0.05)。MED19蛋白的表達(dá)與患者TNM分期相關(guān)(P0.05),與性別、年齡、腫瘤大小、分化程度之間無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。單因素COX分析發(fā)現(xiàn),腫瘤的分期、復(fù)發(fā)情況和MED19蛋白表達(dá)與患者預(yù)后相關(guān)(P0.05),多因素COX分析發(fā)現(xiàn)復(fù)發(fā)情況和MED19蛋白的表達(dá)與患者預(yù)后相關(guān)(P0.05)。單因素和多因素COX分析腫瘤復(fù)發(fā)情況和MED19的表達(dá)與患者預(yù)后相關(guān),而患者性別、年齡、腫瘤大小、腫瘤分期和分化與患者預(yù)后情況無(wú)關(guān)(P0.05)。生存分析顯示MED19高表達(dá)組生存率明顯低于MED19低表達(dá)組。結(jié)論:實(shí)驗(yàn)顯示MED19蛋白表達(dá)與舌癌發(fā)生有關(guān)。分析結(jié)果提示MED19蛋白表達(dá)與舌癌患者淋巴結(jié)轉(zhuǎn)移和TNM分期有關(guān),與年齡、性別及分化程度均無(wú)關(guān)。單因素和多因素COX分析腫瘤復(fù)發(fā)情況和MED19的表達(dá)與患者預(yù)后相關(guān)。生存分析提示MED19高表達(dá)組患者總體生存率較MED19低表達(dá)組明顯較低。
[Abstract]:Objective: most malignant tumors in oral and maxillofacial region belong to squamous cell carcinoma (SCC), which accounts for more than 80% of malignant tumors in maxillofacial region. In our country, it is more common in adult male patients, lymph node metastasis often occurs in the early stage and distant metastasis in the late stage. There is no specific diagnostic index for tongue cancer. Studies have shown that high expression of MED19 can be found in a variety of human tumors, and in vitro, inhibition of MED19 can induce growth inhibition and apoptosis increase in the corresponding tumor cell lines. This study was designed to investigate the expression of MED19 in tongue cancer, and to study the correlation between MED19 and clinical features, and the prognostic survival rate. Methods: from January 2012 to September 2016, 50 cases of tongue cancer specimens from the Department of Pathology of Yantai Yuzhouding Hospital, affiliated to Qingdao University, were collected. All the patients had complete clinical data, no other malignant tumors and no history of radiotherapy and chemotherapy before operation. In addition, 50 paracancerous tissues and 20 normal tissues were selected as control group. The paracancerous tissue was taken from 1cm. The paracancerous tissue was removed from the cancer tissue longer than the 1cm. From January 2012 to June 2014, 24 patients with tongue cancer in the Department of Oral and Maxillofacial surgery, Yantai Yuzhouding Hospital, Qingdao University were reviewed. Data were obtained by review or telephone follow-up. Univariate and multivariate Cox regression analysis was used to analyze the correlation between MED19 and prognosis. Kaplan-Meier was used to analyze the relationship between MED19 and survival rate. Results: the expression of MED19 was high in the nuclei and cytoplasm of tongue cancer cells, and 29 cases were stained brown and yellow in 50 cases of TSCC. The positive rate of MED19 expression was 58%. The expression rate of MED19 was lower in 50 cases than that in the adjacent tissues of 50 cases. The positive rate of MED19 protein was 88.2in the group with lymph node metastasis, and the positive rate of MED19 protein in the group without lymph node metastasis was 42.4% (P < 0.05), and the positive rate of MED19 protein in the group without lymph node metastasis was 42.4% (P < 0.05), and the positive rate of MED19 protein in the group without lymph node metastasis was 42.4% (P < 0.05). The expression of MED19 protein was correlated with TNM stage (P0.05), but not between sex, age, tumor size and differentiation (P0.05). Univariate Cox analysis showed that tumor staging, recurrence and MED19 protein expression were correlated with the prognosis (P0.05), multivariate Cox analysis found that recurrence and MED19 protein expression were related to the prognosis of patients (P0.05). Univariate and multivariate Cox analysis showed that tumor recurrence and MED19 expression were correlated with prognosis, but gender, age, tumor size, tumor stage and differentiation were not correlated with prognosis (P0.05). Survival analysis showed that the survival rate of MED 19 high expression group was significantly lower than that of MED 19 low expression group. Conclusion: MED 19 protein expression is associated with tongue cancer. The results suggested that the expression of MED19 protein was correlated with lymph node metastasis and TNM stage, but not with age, sex and differentiation. Univariate and multivariate Cox analysis of tumor recurrence and MED 19 expression were associated with prognosis. Survival analysis showed that the overall survival rate of patients with high MED 19 expression was significantly lower than that of MED 19 patients with low MED 19 expression.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R739.86

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