本文選題：膀胱尿路上皮癌　切入點：髓源性抑制細胞　出處：《昆明醫(yī)科大學》2014年碩士論文

【摘要】：目的： 通過檢測膀胱尿路上皮癌患者外周血、癌組織及癌旁組織中髓源性抑制細胞(myeloid derived suppressor cells, MDSC)與調(diào)節(jié)性T細胞(regulatory T cells, Treg)的表達水平,探討其與膀胱尿路上皮癌臨床病理特征之間的關(guān)系及它們之間的相關(guān)性,為膀胱尿路上皮癌的早期診斷、治療和判斷預(yù)后提供依據(jù)。 方法： 選取昆明醫(yī)科大學第二附屬醫(yī)院泌尿外科2012年12月至2013年11月收治的膀胱尿路上皮癌患者39例和體檢中心20例健康體檢者,采集其外周血；39例膀胱尿路上皮癌患者手術(shù)后收集切除的癌組織以及距腫瘤2cm以外正常膀胱組織。用流式細胞術(shù)分別檢鋇CD14-CD11b+CD33+MDSC與CD4+CD25+Foxp3+Treg的表達。 結(jié)果： 1.膀胱尿路上皮癌患者外周血中MDSC、Treg的表達顯著高于健康者,差異有統(tǒng)計學意義(p0.05)； 2.膀胱尿路上皮癌癌組織中MDSC、Treg的表達顯著高于癌旁組織,差異有統(tǒng)計學意義(p0.05)； 3.膀胱尿路上皮癌患者外周血、癌組織、癌旁組織中MDSC、Treg的表達水平與臨床分期、組織學分級、淋巴結(jié)有無轉(zhuǎn)移相關(guān)(p0.05),未觀察到MDSC、 Treg表達水平與患者性別、年齡、腫瘤直徑、腫瘤數(shù)量、腫瘤復(fù)發(fā)有關(guān)(P0.05)；臨床分期與組織學分級、淋巴結(jié)有無轉(zhuǎn)移相比,臨床分期與MDSC、Treg的表達水平相關(guān)性更大(P0.05)。 4膀胱尿路上皮癌患者外周血、癌組織、癌癌旁組織中的MDSC與Treg表達水平均呈正相關(guān)關(guān)系,每對數(shù)據(jù)間均有統(tǒng)計學意義(P0.05)。 5膀胱尿路上皮癌患者的外周血及癌組織中的MDSC水平高于癌旁組織中的MDSC(P0.05);膀胱尿路上皮癌患者的外周血及癌旁組織中的Treg水平低于癌組織中的Treg (P0.05)。 結(jié)論： 膀胱尿路上皮癌患者外周血及癌組織中MDCS、Treg細胞的比例明顯增加且與臨床分期、病理分級、淋巴結(jié)有無轉(zhuǎn)移相關(guān),其可能與膀胱尿路上皮癌細胞的免疫逃逸相關(guān),并可能在膀胱尿路上皮癌的發(fā)生發(fā)展中起重要作用,其具有成為膀胱尿路上皮癌免疫治療靶點的潛在價值。
[Abstract]:Objective:. The expression of myeloid derived suppressor cells (MDSCs) and regulatory T cells (Tregs) in peripheral blood, cancer tissues and adjacent tissues of bladder urothelial carcinoma patients were detected. To explore the relationship between bladder urothelial carcinoma and clinicopathological features and their correlation, to provide evidence for early diagnosis, treatment and prognosis of bladder urothelial carcinoma. Methods:. From December 2012 to November 2013, 39 patients with bladder urothelial carcinoma and 20 healthy persons in the center of physical examination were selected from Urology Department, second affiliated Hospital of Kunming Medical University, from December 2012 to November 2013. CD14-CD11b CD33 MDSC and CD4 CD25 Foxp3 Treg were detected by flow cytometry in 39 patients with bladder urothelial carcinoma and normal bladder tissues other than 2cm. Results:. 1. The expression of MDSC-Treg in peripheral blood of patients with bladder urothelial carcinoma was significantly higher than that of healthy controls (P 0.05). 2.The expression of MDSC-Treg in bladder urothelial carcinoma was significantly higher than that in paracancerous tissues (P 0.05). 3.The expression of MDSC-Treg in peripheral blood, cancer tissue and adjacent tissues of bladder urothelial carcinoma was correlated with clinical stage, histological grade and lymph node metastasis (P 0.05). There was no correlation between MDSCand Treg expression and sex, age, tumor diameter. The correlation between clinical stage and histological grade, lymph node metastasis, clinical stage and MDSC-Treg expression level was greater than that between clinical stage and MDSC-Treg expression level. (4) there was a positive correlation between the expression of MDSC and Treg in peripheral blood, cancer tissues and paracancerous tissues of patients with bladder urothelial carcinoma, and there was significant difference between each pair of data (P 0.05). (5) the level of MDSC in peripheral blood and cancer tissue of bladder urothelial carcinoma was higher than that in paracancerous tissue (P 0.05), and the level of Treg in peripheral blood and adjacent tissue of bladder urothelial carcinoma was lower than that in cancer tissue (P 0.05). Conclusion:. The percentage of MDCS- Treg cells in peripheral blood and cancer tissues of patients with bladder urothelial carcinoma was significantly increased and correlated with clinical stage, pathological grade and lymph node metastasis, which may be related to immune escape of bladder urothelial carcinoma cells. It may play an important role in the occurrence and development of bladder urothelial carcinoma, which has potential value as a target of immunotherapy for bladder urothelial carcinoma.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R737.14

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本文編號：1678772