【摘要】：目的研究凋亡蛋白抑制因子(Survivin)和波形蛋白(Vimentin)在腎透明細(xì)胞癌(clear cell renal cell carcinoma, ccRCC)中的表達(dá)，并分析其與ccRCC臨床分期、病理分級(jí)和侵襲轉(zhuǎn)移等惡性生物學(xué)特性的關(guān)系及臨床意義。 方法收集2011年10月至2013年4月河南科技大學(xué)第一附屬醫(yī)院外科手術(shù)切的56例腎透明細(xì)胞癌組織標(biāo)本，年齡32～75歲，，平均年齡57歲，其中男性32例，女性24例。臨床分期按Robson法：I期23例，II期15例，III～I(xiàn)V期18例；其中發(fā)生淋巴結(jié)轉(zhuǎn)移17例。組織學(xué)分級(jí)根據(jù)Fuhrman分級(jí)系統(tǒng)進(jìn)行分級(jí)：I級(jí)19例、II級(jí)26例、III～I(xiàn)V級(jí)11例；同時(shí)選取25例癌旁及13例正常腎組織作為對(duì)照組，所有選取病例術(shù)前均未進(jìn)行放、化療，術(shù)后經(jīng)病理證實(shí)。所有標(biāo)本10％福爾馬林液固定，常規(guī)石蠟包埋，采用免疫組化SP法檢測(cè)Survivin和Vimentin在腎透明細(xì)胞癌、癌旁及正常腎組織中的表達(dá)情況，并分析其與腎透明細(xì)胞癌惡性生物學(xué)特性的關(guān)系及兩者的相關(guān)性。本實(shí)驗(yàn)數(shù)據(jù)采用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)分析，以P0.05為差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果Survivin陽(yáng)性表達(dá)為棕黃色顆粒，主要定位于胞質(zhì)，部分胞核亦可見(jiàn)著色。Survivin在56例腎透明細(xì)胞癌標(biāo)本中表達(dá)顯著升高，其在腎透明細(xì)胞癌中的表達(dá)陽(yáng)性率與癌旁腎組織及正常腎組織相比，差異有顯著統(tǒng)計(jì)學(xué)意義(P0.01)。Vimentin陽(yáng)性表達(dá)為棕黃色顆粒，主要定位于胞質(zhì)，靠近胞膜。Vimentin在56例腎透明細(xì)胞癌標(biāo)本中表達(dá)顯著高于癌旁及正常腎組織，其在實(shí)驗(yàn)組中的陽(yáng)性表達(dá)率與對(duì)照組相比，有顯著差異性(P0.01)。隨著腫瘤臨床分期和病理分級(jí)的升高，Survivin和Vimentin的表達(dá)逐漸增強(qiáng)，其在腎透明細(xì)胞癌的不同臨床分級(jí)及病理分級(jí)中表達(dá)有顯著差異性(P0.01)，而兩者的表達(dá)與患者的性別及年齡均無(wú)關(guān)，差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。Spearman等級(jí)相關(guān)分析顯示Survivin和Vimentin的表達(dá)呈顯著正相關(guān)(r=0.566, P0.01)。 結(jié)論1、Survivin和Vimentin在腎透明細(xì)胞癌組織中的表達(dá)明顯高于癌旁及正常腎組織，提示Survivin和Vimentin在腎透明細(xì)胞癌的發(fā)生發(fā)展過(guò)程中發(fā)揮重要的作用。 2、腎透明細(xì)胞癌中Survivin和Vimentin的表達(dá)與臨床分期、病理分級(jí)及有無(wú)淋巴結(jié)轉(zhuǎn)移有關(guān)，而與性別及年齡無(wú)關(guān)，提示Survivin和Vimentin可能與腎透明細(xì)胞癌的浸潤(rùn)和轉(zhuǎn)移密切相關(guān)。 3、Survivin和Vimentin在腎透明細(xì)胞癌中的表達(dá)呈顯著正相關(guān)，提示兩者可能在腎透明細(xì)胞癌的發(fā)生發(fā)展過(guò)程中存在協(xié)同作用，聯(lián)合兩個(gè)因子的檢測(cè)可為腎透明細(xì)胞癌的惡性生物學(xué)特性的判斷提供重要的信息。
[Abstract]:Objective to study the expression of apoptosis inhibitor (Survivin) and vimentin (Vimentin) in renal clear cell carcinoma (RCC) (clear cell renal cell carcinoma, ccRCC), and to analyze their correlation with ccRCC clinical stage. The relationship between pathological grading and invasion and metastasis of malignant biological characteristics and its clinical significance. Methods from October 2011 to April 2013, 56 specimens of renal clear cell carcinoma were collected from the first affiliated Hospital of Henan University of Science and Technology. The average age was 57 years, including 32 males and 24 females. According to Robson's method, 23 cases had stage I, 15 cases had stage II and 18 cases had stage III~IV, among which 17 cases had lymph node metastasis. According to the Fuhrman classification system, 19 cases were classified as I grade, 26 cases as II grade and 11 cases as III~IV grade. 25 cases of cancer and 13 cases of normal renal tissue were selected as control group. All the selected cases were not treated with chemotherapy before operation and confirmed by pathology after operation. All specimens were fixed in 10% formalin solution and embedded in paraffin. The expression of Survivin and Vimentin in renal clear cell carcinoma (RCC) and normal renal tissues was detected by immunohistochemical SP method. The relationship between it and malignant biological characteristics of renal clear cell carcinoma was analyzed. The data of this experiment were analyzed by SPSS17.0 software, and the difference was statistically significant with P0.05. Results the positive expression of Survivin was brown granules, mainly located in the cytoplasm and stained in some nuclei. The expression of Survivin was significantly increased in 56 cases of renal clear cell carcinoma. The positive rate of P0.01). Vimentin expression in renal clear cell carcinoma was significantly higher than that in adjacent renal tissues and normal renal tissues (P0.01). Vimentin positive expression was brown granules, mainly located in cytoplasm. The expression of Vimentin in 56 cases of renal clear cell carcinoma was significantly higher than that in adjacent and normal renal tissues. The positive expression rate of Vimentin in the experimental group was significantly higher than that in the control group (P0.01). With the increase of clinical stage and pathological grade, the expression of Survivin and Vimentin increased gradually, and there were significant differences in the expression of Survivin and Vimentin in different clinical and pathological grades of renal clear cell carcinoma (P0.01). There was no significant difference between the expression of Survivin and Vimentin (P0.05). Spearman grade correlation analysis showed that there was a significant positive correlation between the expression of Survivin and Vimentin (r = 0.566, P0.01). Conclusion 1the expression of survivin and Vimentin in renal clear cell carcinoma is significantly higher than that in adjacent normal renal tissue, suggesting that Survivin and Vimentin play an important role in the development of renal clear cell carcinoma. 2. The expression of Survivin and Vimentin in renal clear cell carcinoma was related to clinical stage, pathological grade and lymph node metastasis, but not to sex and age. It suggested that Survivin and Vimentin might be closely related to invasion and metastasis of renal clear cell carcinoma. 3The expression of survivin and Vimentin in renal clear cell carcinoma was positively correlated, suggesting that there may be a synergistic effect between survivin and Vimentin in the development of renal clear cell carcinoma. Combined detection of two factors may provide important information for the judgement of malignant biological characteristics of renal clear cell carcinoma.
【學(xué)位授予單位】：河南科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R737.11

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