本文選題：腫瘤 + 組織因子陽性微粒��； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:(1)檢測惡性實體瘤(malignant solid tumors)患者血漿中組織因子陽性微粒(tissue factor positive microparticles,TF+MP)的表達水平,初步探討其在惡性實體瘤中的表達;(2)比較在惡性實體瘤不同分期中TF+MP的表達水平,探討其是否與腫瘤進展相關;(3)比較惡性實體瘤合并血栓形成中TF+MP的表達水平,探討TF+MP在腫瘤合并血栓形成中的作用;(4)檢測惡性實體瘤在麻醉前后TF+MP表達水平,探討麻醉因素對腫瘤患者中TF+MP的影響;(5)檢測惡性實體瘤患者在手術前后中TF+MP表達水平,探討惡性實體瘤患者手術后易發(fā)血栓形成的可能原因。方法:收集我院住院并行手術治療的惡性實體瘤患者36例為實驗組及健康體檢者29例為對照組。檢測惡性實體瘤患者體內(nèi)TF+MP的表達水平并比較腫瘤不同分期、合并血栓形成以及麻醉前后和手術前后中TF+MP的變化情況:對照組抽取清晨空腹靜脈血,實驗組分別于麻醉前、麻醉后和手術后抽取空腹靜脈血,兩次離心處理后得到乏血小板血漿(platelet poor plasma,PPP),采取免疫熒光技術用FITC-Annexin-Ⅴ抗體和PE-TF抗體標記目的顆粒TF+MP,然后采用流式細胞儀進行檢測并分析目的顆粒TF+MP:直徑0.1-1.0um、FITC-Annexin-Ⅴ抗體和PE-TF抗體雙標陽性。最后比較各組中TF+MP的表達情況。結果:(1)TF+MP在惡性實體腫瘤患者與健康對照組之間的整體表達水平:TF+MP在惡性實體瘤患者體內(nèi)的表達比健康組中的表達升高:(25.45±16.04)%vs(11.31±6.22)%,t=3.934,P0.001,提示在惡性實體瘤患者中TF+MP高表達。(2)TF+MP在腫瘤各分期中的表達水平:在Ⅰ期腫瘤患者體內(nèi)的TF+MP水平與健康組無明顯差異:(15.22±12.93)%vs(11.31±6.22)%,t=1.147,P=0.261;Ⅱ-Ⅳ期腫瘤患者的TF+MP表達明顯比Ⅰ期升高(P0.05),而Ⅱ期、Ⅲ期和Ⅳ期腫瘤患者之間表達的TF+MP無明顯變化(P0.05):(15.22±12.93)%vs(28.89±8.24)%vs(28.03±19.38)%vs(33.60±7.85)%。提示進展期的惡性實體瘤表達的TF+MP明顯增高。(3)TF+MP在惡性實體瘤合并VTE患者中的表達水平:TF+MP在惡性實體瘤合并VTE的患者的表達比未合并VTE的患者有顯著升高趨勢:33.0%,提示TF+MP增高在惡性實體瘤合并血栓形成患者中可能發(fā)揮了重要作用。(4)TF+MP在惡性實體瘤患者麻醉前后的表達水平:在惡性實體瘤患者麻醉前后體內(nèi)TF+MP表達水平無明顯變化:(25.45±16.04)%vs(24.68±15.05)%,t=0.206,P=0.838,提示麻醉因素對患者術后TF+MP的表達無顯著影響。(5)TF+MP在惡性實體瘤患者手術前后的表達水平:惡性實體瘤患者手術前后比較,TF+MP的表達在術后有所增高:(24.68±15.05)%vs(32.99±17.92)%,t=2.074,P=0.042,提示手術可促進腫瘤患者體內(nèi)TF+MP的釋放或表達。結論:(1)TF+MP在惡性實體瘤患者中的表達高于健康對照組,且II、III、IV期明顯高于I期,提示惡性實體瘤TF+MP高表達,而且隨著腫瘤進展其表達水平提高,故而TF+MP高表達可能提示惡性實體瘤的發(fā)生并且反映腫瘤的進展;(2)TF+MP可能與惡性實體瘤易發(fā)血栓形成密切相關;(3)惡性實體瘤患者術后易發(fā)血栓形成可能與手術促進TF+MP的高表達有關,而麻醉因素不影響TF+MP表達,與惡性實體瘤患者術后血栓形成無關。綜上所述,TF+MP可能與惡性實體瘤的發(fā)生、進展及血栓形成相關,很可能是惡性實體瘤患者手術后易發(fā)血栓的重要因素。
[Abstract]:Objective: (1) to detect the expression level of tissue factor positive particles (tissue factor positive microparticles, TF+MP) in the plasma of malignant solid tumors, and to explore its expression in malignant solid tumor; (2) to compare the expression level of TF+MP in malignant solid tumor, and to discuss whether it is with the progression of tumor. (3) to compare the expression level of TF+MP in malignant solid tumor and thrombosis, to explore the role of TF+MP in the formation of tumor and thrombosis; (4) to detect the level of TF+MP expression before and after anesthesia and to explore the effect of anesthetic factors on the TF+MP in the tumor patients; (5) to detect the expression level of TF+MP in patients with malignant solid tumor before and after operation, Methods: 36 patients with malignant solid tumors in our hospital were collected and 36 cases of malignant solid tumors were collected in our hospital and 29 patients in the physical examination were used as the control group. The expression level of the patients with malignant solid tumor was detected and the different stages of the tumor were compared, the thrombosis and the anesthesia were combined. The change of TF+MP during and before and after the operation: the control group took the early morning empty venous blood, the experimental group took the empty abdominal vein blood before anesthesia, after anesthesia and after the operation, and then obtained the platelet poor plasma (PPP) after the two centrifugation. The immunofluorescence technique was used to label the FITC-Annexin- V antibody and PE-TF antibody. The particle TF+MP was then detected by flow cytometry and analyzed the target particle TF+MP: diameter 0.1-1.0um, FITC-Annexin- V antibody and PE-TF antibody positive. Finally, the expression of TF+MP was compared in each group. Results: (1) the overall expression level of TF+MP between the patients with malignant solid tumor and the healthy control group: TF+MP in malignant solid tumor. The expression in the patient was higher than that in the healthy group: (25.45 + 16.04)%vs (11.31 + 6.22)%, t=3.934, P0.001, indicating high expression of TF+MP in patients with malignant solid tumor. (2) the expression level of TF+MP in the various stages of the tumor: there was no significant difference in the level of TF+MP from the healthy group in stage I tumor patients: (15.22 + 12.93)%vs (11.31 + 6.22)%, t=1.14 7, P=0.261; the TF+MP expression of the tumor patients in stage II - IV was significantly higher than that in phase I (P0.05), while there was no significant change in the expression of TF+MP between stage II, stage III and IV tumor patients (P0.05): (15.22 + 12.93)%vs (28.89 + 8.24)%vs (28.03 + 19.38)%vs (33.60 + 7.85)%, suggesting that the expression of malignant solid tumor in the advanced stage was significantly higher. (3) TF+MP in malignant The expression level in patients with solid tumor combined with VTE: the expression of TF+MP in patients with malignant solid tumors with VTE is significantly higher than those without VTE: 33%, the increase in TF+MP may play an important role in the patients with malignant solid tumor and thrombosis. (4) the expression level of TF+MP in patients with malignant solid tumor before and after anesthesia: There was no significant change in the level of TF+MP expression in the patients with malignant solid tumor before and after anesthesia: (25.45 + 16.04)%vs (24.68 + 15.05)%, t=0.206, P=0.838, suggesting that the anesthetic factors have no significant influence on the expression of TF+MP after operation. (5) the level of TF+MP in the patients with malignant solid tumor before and after operation: the expression of TF+MP in patients with malignant solid tumor before and after operation. The increase after operation: (24.68 + 15.05)%vs (32.99 + 17.92)%, t=2.074, P=0.042, suggesting that the operation can promote the release or expression of TF+MP in the tumor patients. Conclusion: (1) the expression of TF+MP in the patients with malignant solid tumor is higher than that of the healthy control group, and the II, III, IV stage is higher than the I stage, suggesting the high expression of TF+MP in the malignant solid tumor, and along with the tumor progression. The high expression level of TF+MP may indicate the occurrence of malignant solid tumor and reflect the progression of tumor; (2) TF+MP may be closely related to the formation of easy thrombosis in malignant solid tumors. (3) the formation of easy thrombosis in patients with malignant solid tumor may be related to the high expression of TF+ MP in operation, and the anesthesia factors do not affect the expression of TF+MP. It is not related to postoperative thrombosis in patients with malignant solid tumors. To sum up, TF+MP may be associated with the occurrence, progression and thrombosis of malignant solid tumors. It is likely to be an important factor in the easy onset of thrombosis in patients with malignant solid tumor after surgery.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R730.5

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