發(fā)布時間：2018-05-25 15:38

  本文選題：前列腺癌 + TGF-β1　； 參考：《天津醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的 前列腺癌(Prostate cancer, PCa)是男性最常見的惡性腫瘤之一,并是發(fā)達(dá)國家男性常見死因之一。其發(fā)生、發(fā)展是基因調(diào)控失衡的結(jié)果,生物學(xué)特性與多種癌基因、生長因子密切相關(guān)。有研究表明,TGF-β1、VEGF蛋白表達(dá)與腫瘤的發(fā)生、進展關(guān)系密切。但TGF-β1、VEGF對于前列腺癌臨床分期及在冷凍治療前后的預(yù)測價值如何,未見文獻報道。據(jù)此,本研究采用免疫組化方法檢測病理標(biāo)本中TGF-β1、VEGF的表達(dá)情況,分析TGF-β1、VEGF表達(dá)情況在前列腺癌臨床分期中的臨床意義；ELISA法檢測其在冷凍消融治療前后血漿中的表達(dá)水平,分析TGF-β1、VEGF表達(dá)情況與冷凍治療療效(PSA緩解率)之間的相關(guān)性,以期為不同臨床分期前列腺癌患者預(yù)后評估及冷凍治療術(shù)后療效分析提供前期線索。 材料和方法 1.調(diào)取2008年1月-2011年12月天津醫(yī)科大學(xué)腫瘤醫(yī)院收治76例的前列腺癌及40例前列腺增生病理蠟塊標(biāo)本,免疫組化檢測標(biāo)本中TGF-β1、VEGF的表達(dá)情況,分析其與臨床分期及預(yù)后的相關(guān)聯(lián)系。 2.收集2011年11月-2012年12月天津醫(yī)科大學(xué)腫瘤醫(yī)院我科行冷凍消融治療的前列腺癌患者,分別于術(shù)前和術(shù)后7d收集外周血血漿標(biāo)本,采用ELISA法檢測患者血漿中TGF-β1、VEGF的含量。分析其表達(dá)情況與患者冷凍術(shù)后3月PSA緩解率的相關(guān)性。 結(jié)果 1. TGF-β1蛋白在前列腺癌中的高表達(dá)率為73.68%,在前列腺增生標(biāo)本中高表達(dá)率為35.00%,組間差異具有統(tǒng)計學(xué)意義。在Gleason評分2-6分、7分、8-10分三組間的高表達(dá)率分別為46.15%、57.89%、88.64%,組間比較,差異具有統(tǒng)計學(xué)意義(P0.001)。在無骨轉(zhuǎn)移組中,高表達(dá)率為60.61%,合并骨轉(zhuǎn)移組的TGF-β1高表達(dá)率為83.72%,組間差異顯著,有統(tǒng)計學(xué)意義(P=0.023)。在PSA分組、臨床分期組間表達(dá)差異無統(tǒng)計學(xué)意義(P0.05)。 2. VEGF蛋白在前列腺癌標(biāo)本中的高表達(dá)率為63.16%,前列腺增生標(biāo)本中的高表達(dá)率為37.50%,組間差異具有統(tǒng)計學(xué)意義(P=0.006)。在Gleason評分2-6分、7分、8-10分三組間的高表達(dá)率分別為46.15%、47.36%、75.00%,組間差異具有統(tǒng)計學(xué)意義(P0.05)。臨床分期Ⅱ期、Ⅲ期、Ⅳ期的高表達(dá)率分別為57.14%、40.91%、74.47%,組間差異具有統(tǒng)計學(xué)意義(P0.05)。在無骨轉(zhuǎn)移組中,高表達(dá)率為46.88%,合并骨轉(zhuǎn)移組的TGF-β1高表達(dá)率為75.00%,組間差異有統(tǒng)計學(xué)意義(P=0.012)。在PSA分組間的表達(dá)差異無統(tǒng)計學(xué)意義(P0.05)。 3.前列腺癌組織中VEGF與TGF-β1表達(dá)呈正相關(guān)性(P0.001),PCa患者中位PFS在TGF-β1(+)、VEGF (+)組較TGF-β1(-)、VEGF (-)組明顯延長,組間差異具有統(tǒng)計學(xué)意義(P=0.015),而OS在組間比較,差異無統(tǒng)計學(xué)意義(P=0.07)。 4.冷凍消融術(shù)后3月PSA緩解組TGF-β1表達(dá)水平較術(shù)前明顯下降,而PSA未緩解組TGF-β1表達(dá)水平明顯升高,差異具有統(tǒng)計學(xué)意義(P0.05)。PSA緩解組VEGF表達(dá)水平明顯下降,差異具有統(tǒng)計學(xué)意義(P0.01),而PSA未緩解組表達(dá)水平明顯升高,但未見統(tǒng)計學(xué)差異(P=0.079)。 結(jié)論 1. TGF-β1蛋白在前列腺癌中高表達(dá),并隨Gleason評分的增高,TGF-β1的表達(dá)率明顯增高。合并骨轉(zhuǎn)移組較無骨轉(zhuǎn)移組的TGF-β1高表達(dá)率也明顯增高。 2. VEGF蛋白在前列腺癌中高表達(dá),并隨Gleason評分的增高,VEGF的表達(dá)率明顯增高。臨床分期Ⅳ期的VEGF陽性高表達(dá)率較Ⅱ期、Ⅲ期明顯增高。在合并骨轉(zhuǎn)移組的VEGF較無骨轉(zhuǎn)移組也明顯增高。 3.前列腺癌組織中VEGF與TGF-β1表達(dá)呈正相關(guān)性,二者可能在前列腺癌的發(fā)生、發(fā)展過程中起協(xié)同作用。 4.冷凍消融術(shù)后3月PSA緩解組TGF-β1、VEGF表達(dá)水平呈現(xiàn)明顯下降趨勢,而PSA未緩解組表達(dá)水平明顯升高。對比冷凍治療前后TGF-β1、VEGF的表達(dá)水平,可用來預(yù)測冷凍治療的療效,可能具有臨床指導(dǎo)意義。
[Abstract]:Purpose

Prostate cancer ( PCa ) is one of the most common malignant tumors in males and is one of the most common causes of death in developed countries . The development of TGF - 尾1 and VEGF is closely related to the occurrence and progression of tumors .
The correlation between the expression of TGF - 尾1 , VEGF and the efficacy of cryotherapy ( PSA response rate ) was analyzed by ELISA in order to provide early clues for the prognosis of patients with different clinical stages of prostate cancer and the analysis of curative effect after cryotherapy .

Materials and Methods

1 . The expression of TGF - 尾1 and VEGF was detected in 76 cases of prostate cancer and 40 cases of benign prostatic hyperplasia from January 2008 to December 2011 , and the correlation between clinical stage and prognosis was analyzed .

2 . Collect the peripheral blood plasma samples from November 2011 to December 2012 at the Oncology Hospital of Tianjin Medical University , and collect the plasma samples from peripheral blood before and after operation . The correlation between the expression of TGF - 尾1 and VEGF in the plasma of patients was analyzed by ELISA .

Results

1 . The high expression rate of TGF - 尾1 protein in prostate cancer was 73.68 % , and the high expression rate was 35.00 % in benign prostatic hyperplasia . The high expression rate of TGF - 尾1 was 46.15 % , 57.89 % , 88.64 % , and the difference was statistically significant ( P = 0.023 ) .

2 . The high expression rate of VEGF protein in prostate cancer specimens was 63.16 % , and the high expression rate was 37.50 % in benign prostatic hyperplasia . The high expression rates were 46.15 % , 47.36 % and 75.00 % in the group of Gleason score 2 - 6 , 7 and 8 - 10 , respectively .

3 . The expression of VEGF and TGF - 尾1 was positively correlated with the expression of TGF - 尾1 ( + ) , VEGF ( + ) , TGF - 尾1 ( - ) and VEGF ( - ) in PCa patients .

4 . The expression level of TGF - 尾1 in PSA response group decreased significantly in the PSA response group after cryoablation compared with that before operation ( P0.05 ) . The level of VEGF expression in PSA response group decreased significantly ( P0.01 ) , but the level of VEGF expression in PSA response group was significantly increased , but there was no statistical difference ( P = 0.079 ) .

Conclusion

1 . TGF - 尾1 was highly expressed in prostate cancer , and the expression rate of TGF - 尾1 increased significantly with the increase of Gleason score .

2 . VEGF protein was highly expressed in prostate cancer and increased with Gleason score . The high expression rate of VEGF in stage 鈪，

本文編號：1933777