發(fā)布時(shí)間：2018-02-16 05:16

  本文關(guān)鍵詞： 乳房Paget病 乳房外Paget病 免疫組化 MUC5AC 骨橋蛋白 Caveolin-1　出處：《大連醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：背景 Paget病(Paget 's disease,PD)首次是由英國(guó)外科物理學(xué)家James Paget在1874年報(bào)道，其發(fā)病年齡一般為40～60歲，比較容易發(fā)生于乳頭及乳暈部和富有大汗腺的區(qū)域。乳頭及乳暈處的Paget病稱為乳房Paget病(Mammary Paget 'sdisease,MPD)，其他部位的稱為乳房外Paget病(Extramammary Paget 'sdisease,EPD)。該病特點(diǎn)為發(fā)病部位可見界限清楚的紅色斑片，其表面有滲出、結(jié)痂或角化性鱗屑，可以逐漸向周圍擴(kuò)大，，經(jīng)數(shù)月或數(shù)年后常浸潤(rùn)周邊或者深層，嚴(yán)重者甚至發(fā)生潰瘍，自覺不同程度的瘙癢，少數(shù)可有疼痛。 PD的發(fā)病機(jī)制和組織來源一直存在著很大的爭(zhēng)議。人們利用免疫組化技術(shù)對(duì)PD進(jìn)行不斷地深入研究，對(duì)PD的發(fā)病機(jī)制和組織來源有了更多的了解。絕大多數(shù)學(xué)者認(rèn)為MPD的發(fā)生和發(fā)展與乳腺癌有很大的關(guān)聯(lián)，認(rèn)為MPD可能是乳腺原位腺癌的表皮轉(zhuǎn)移。而EPD則與結(jié)腸、直腸、肛門及鄰近內(nèi)臟器官的惡性腫瘤或浸潤(rùn)性腫瘤有一定的關(guān)聯(lián)。本文研究了MUC5AC(Gastric mucin M1,胃粘液素抗原)、OPN(Osteopontin,骨橋蛋白)和Caveolin-1(小窩蛋白1)三種免疫標(biāo)志物在MPD和EPD中的表達(dá)情況，并探討其表達(dá)意義，期望可以進(jìn)一步揭示MPD和EPD的組織來源。 目的 通過研究MUC5AC、骨橋蛋白和Caveolin-1在MPD和EPD中的表達(dá)情況，探討MPD和EPD的組織學(xué)起源及其表達(dá)意義。 方法 對(duì)沈陽軍區(qū)總醫(yī)院皮膚科已經(jīng)明確診斷的26例PD患者(其中MDP和EDP患者各13例)的病理組織蠟塊和5例正常組織蠟塊的進(jìn)行免疫組化染色，比較這三種抗體在MPD和EPD中的表達(dá)情況。 結(jié)果 1. MUC5AC的表達(dá)情況：MUC5AC在正常表皮的細(xì)胞質(zhì)中弱陽性表達(dá)，表達(dá)率為60%；在PD的細(xì)胞質(zhì)中表達(dá)，其中強(qiáng)陽性表達(dá)率為30.77%，陽性表達(dá)率為26.92%，弱陽性表達(dá)率為30.77%；在EPD的細(xì)胞質(zhì)中表達(dá)，其中強(qiáng)陽性表達(dá)率為46.15%，陽性表達(dá)率為23.08%，弱陽性表達(dá)率為23.08%；在MPD的細(xì)胞質(zhì)中表達(dá)，其中強(qiáng)陽性表達(dá)率為15.38%，陽性表達(dá)率為30.77%，弱陽性表達(dá)率為38.46%。 MUC5AC在EPD中強(qiáng)陽性表達(dá)率為46.15%，而在MPD中的強(qiáng)陽性表達(dá)率為15.38%，表明MUC5AC在EPD中的強(qiáng)陽性表達(dá)率明顯高于MPD；在EPD中的陽性表達(dá)率為23.08%，而在MPD中的陽性表達(dá)率為30.77%，表明MUC5AC在MPD中的陽性表達(dá)率略高于EPD；在EPD中的弱陽性表達(dá)率為23.08%，而在MPD中的弱陽性表達(dá)率為38.46%，表明MUC5AC在MPD中的弱陽性表達(dá)率略高于EPD�？傮w來說，MUC5AC在EPD中的表達(dá)率要高于MPD。而統(tǒng)計(jì)學(xué)結(jié)果顯示P=0.1210.05，MUC5AC在EPD和MPD的表達(dá)上沒有差異。 2. OPN的表達(dá)情況：OPN在正常表皮的細(xì)胞質(zhì)中表達(dá)，強(qiáng)陽性率為20%，陽性率為40%；在PD的細(xì)胞質(zhì)中有表達(dá)，其中強(qiáng)陽性表達(dá)率為15.39%，陽性表達(dá)率為26.92%，弱陽性表達(dá)率為50%；在EPD的細(xì)胞質(zhì)中表達(dá)，其中強(qiáng)陽性表達(dá)率為23.08%，陽性表達(dá)率為38.46%，弱陽性表達(dá)率為38.46%；在MPD的細(xì)胞質(zhì)中表達(dá)，其中強(qiáng)陽性表達(dá)率為7.69%，陽性表達(dá)率為15.38%，弱陽性表達(dá)率為69.23%。 OPN在EPD中的強(qiáng)陽性表達(dá)率為23.08%，而在MPD中的強(qiáng)陽性表達(dá)率為7.69%，表明OPN在EPD中的強(qiáng)陽性表達(dá)率明顯高于MPD；OPN在EPD中的陽性表達(dá)率為38.46%，而在MPD中的陽性表達(dá)率為15.38%，表明OPN在EPD中的陽性表達(dá)率高于MPD；在EPD中的弱陽性表達(dá)率為38.46%，而在MPD中的弱陽性表達(dá)率為69.23%，表明OPN在MPD中的弱陽性表達(dá)率高于EPD�？傮w來說，OPN在EPD中的表達(dá)率要高于MPD。統(tǒng)計(jì)學(xué)結(jié)果顯示P=0.0450.05， OPN在EPD和MPD的表達(dá)上有差異。 3. Caveolin-1的表達(dá)情況：Caveolin-1在正常表皮的細(xì)胞膜/細(xì)胞質(zhì)中均為弱陽性表達(dá)，表達(dá)率為100%；在PD的細(xì)胞膜/細(xì)胞質(zhì)中均有表達(dá)，強(qiáng)陽性表達(dá)率為15.39%，陽性表達(dá)率為50%，弱陽性表達(dá)率為26.92%；在EPD的細(xì)胞膜/細(xì)胞質(zhì)中有陽性和弱陽性表達(dá)，其表達(dá)率分別為61.54%、30.77%；在MPD的細(xì)胞膜/細(xì)胞質(zhì)中均有表達(dá)，強(qiáng)陽性表達(dá)率為30.77%，陽性表達(dá)率為38.46%，弱陽性表達(dá)率為23.08%。 Caveolin-1在EPD中的無強(qiáng)陽性表達(dá)，而在MPD中的強(qiáng)陽性表達(dá)率為30.77%，提示Caveolin-1在MPD中的強(qiáng)陽性表達(dá)率明顯高于EPD�？傮w來說，Caveolin-1在MPD中的表達(dá)率要高于EPD。統(tǒng)計(jì)學(xué)結(jié)果顯示P=0.2220.05，Caveolin-1在EPD和MPD的表達(dá)上沒有差異。 結(jié)論 1.MUC5AC在EPD和MPD中的表達(dá)無差別； 2.OPN在EPD和MPD中的表達(dá)有顯著差異(P=0.0450.05)； 3.Caveolin-1在EPD和MPD中的表達(dá)無差別。
[Abstract]:Background Paget ' s disease ( PD ) was first reported in 1874 by James Paget , a British surgeon , whose age is generally between 40 and 60 years old and is relatively easy to occur in the nipple and areola part and regions with large sweat glands . Paget ' s disease at the nipple and areola is called breast Paget ' s disease , and the other part is called extramammary Paget ' s disease ( Extramammary Paget ' s disease , EPD ) . The disease is characterized by a clear red spot on the surface of the disease , which has exudation , scabs or keratotic scales , and can gradually expand to the periphery . After months or years , it can infiltrate the periphery or the deep layer , and the serious person even has ulcer , and can feel different degrees of itching , and a few can have pain . This paper studies the expression of three kinds of immune markers such as MUC5AC and Caveolin - 1 , and discusses the significance of the expression of the three markers of MUC5AC and Caveolin - 1 . Purpose By studying the expression of MUC5AC , bone bridge protein and Caveolin - 1 , the histological origin and its expression significance were discussed . method Immunohistochemical staining was performed in 26 PD patients ( 13 patients with MDP and EDP ) and 5 normal tissue wax blocks in Department of Dermatology of Shenyang Military Region . Results 1 . MUC5AC expression : MUC5AC was weakly positive in the cytoplasm of normal epidermis , the expression rate was 60 % , the positive rate of expression was 30.77 % , the positive expression rate was 26.92 % , the weak positive expression rate was 23.08 % , the positive expression rate was 15.38 % , the positive expression rate was 30.77 % , and the weak positive expression rate was 38.46 % . The strong positive rate of MUC5AC in EPD was 46.15 % , and the positive rate of expression of MUC5AC was 15.38 % . The positive rate of MUC5AC was 23.08 % in EPD . The positive rate of MUC5AC was 23.08 % in EPD . 2 . The positive expression rate was 15.39 % , the positive expression rate was 26.92 % , the weak positive expression rate was 38.46 % , the positive expression rate was 38.46 % , the weak positive expression rate was 38.46 % , the positive expression rate was 15.38 % , and the weak positive expression rate was 69.23 % . The strong positive expression rate in EPD was 23.08 % , and the strong positive expression rate in EPD was 7.69 % . The positive expression rate in EPD was 38.46 % , whereas the positive expression rate was 38.46 % in EPD . The positive expression rate in EPD was 38.46 % . The expression rate in EPD was higher than that in EPD . 3 . The expression of Caveolin - 1 was found to be weakly positive in the cell membrane / cytoplasm of the normal epidermis , the expression rate was 100 % , the positive expression rate was 15.39 % , the positive expression rate was 50 % , the weak positive expression rate was 26.92 % , the positive expression rate was 30.77 % , the positive rate of expression was 30.77 % , the positive expression rate was 38.46 % , and the weak positive expression rate was 23.08 % . The positive expression rate of Caveolin - 1 was 30.77 % . The expression rate of Caveolin - 1 was higher than that in EPD . Conclusion 1 . There was no difference in the expression of MUC5AC in EPD and mpd ; 2 . There was a significant difference in the expression between EPD ( P = 0.0450.05 ) and EPD ( P = 0.0450.05 ) . 3 . The expression of Caveolin - 1 in EPD was no difference .

【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R739.5

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