本文選題：△Np73 + p53�。� 參考：《昆明醫(yī)學(xué)院》2010年碩士論文

【摘要】： 目的：應(yīng)用免疫組織化學(xué)技術(shù)對p73異構(gòu)體(△Np73)在皮膚非黑素惡性腫瘤(鱗狀細(xì)胞癌、基底細(xì)胞癌、鮑溫病)、癌前病變(日光性角化病)、良性增殖性疾病(尋常型銀屑病、脂溢性角化癥)及正常人皮膚中的表達(dá)進(jìn)行對照研究,同時與p53(在本文除非特別指出,均為突變型)在這些疾病中的表達(dá)進(jìn)行對照。初步探討△Np73在皮膚非黑素惡性腫瘤中的表達(dá)和意義,及其在腫瘤惡性程度及預(yù)后評估中的實際應(yīng)用價值,以及△Np73與p53在良惡性增殖性疾病中表達(dá)的相關(guān)性。 方法：收集、整理昆明醫(yī)學(xué)院第一臨床學(xué)院皮膚科病理室及病理科保存的符合診斷標(biāo)準(zhǔn)的皮膚高、中、低分化鱗狀細(xì)胞癌(SCC)60例及基底細(xì)胞癌(BCC)、鮑溫病(BD)、日光性角化病(AK)、尋常型銀屑病(PS)、脂溢性角化癥(SK)各20例,并選取我科皮膚手術(shù)室及頜面外科手術(shù)切除的正常人皮膚(skin)10例。經(jīng)過脫水、包埋、切片、染色等步驟,應(yīng)用免疫組化技術(shù)對切片進(jìn)行△Np73及p53的染色,最后評分,統(tǒng)計、分析各病種陽性病例數(shù)之間的差異以及△Np73、p53兩個指標(biāo)之間的相關(guān)性。 結(jié)果：p53在所有病種中均有陽性表達(dá),但在皮膚非黑素惡性腫瘤(SCC、BCC、BD)和癌前病變(AK)中的表達(dá)陽性率明顯超過良性增殖性疾病及正常人皮膚,差異有顯著性(P0.05),非黑素惡性腫瘤(SCC、BCC、BD)與癌前病變(AK)之間的表達(dá)陽性率無顯著性差異(PO.05)：△Np73在全部惡性腫瘤(SCC、BCC、BD)、部分良性增殖性病(PS)及癌前病變(AK)均有陽性表達(dá),在部分良性增殖性病(SK)及正常人皮膚(skin)中無表達(dá),其中SCC與AK的表達(dá)率明顯高于其它病種,差異有統(tǒng)計學(xué)意義(P＜0.05),兩者之間的差異無顯著性差異(P0.05);△Np73蛋白在各病種中的陽性表達(dá)率與發(fā)病部位(曝光部位與非曝光部位)、患者性別、年齡均無統(tǒng)計學(xué)差異(P0.05)；△Np73和p53在SCC中的表達(dá)呈正相關(guān)(rs=0.348,P=0.007),在其它病種中的表達(dá)無相關(guān)性(P0.05)。 結(jié)論：p53(突變型)陽性對診斷及鑒別良惡性增殖性疾病有一定意義,但在鑒別皮膚癌前病變與非黑素惡性腫瘤方面特異性較差；△Np73在SCC、AK的診斷中具有比較特異的診斷價值,尤其在與其他疾病的鑒別診斷中可能具有較強(qiáng)的實際應(yīng)用價值,但對SCC病理分級無明顯意義；△Np73蛋白的陽性表達(dá)率與患者的年齡、性別、發(fā)病部位無顯著相關(guān)性；△Np73和p53在SCC中的表達(dá)具有相關(guān)性,提示兩者在惡性腫瘤的發(fā)病中關(guān)系密切；聯(lián)合應(yīng)用△Np73和p53的可能對良惡性疾病的鑒別診斷更具有臨床意義；△Np73與皮膚非黑素惡性腫瘤之間的復(fù)雜關(guān)系仍不十分清楚,尚需要更多的大樣本量及具有詳細(xì)臨床資料的病例研究進(jìn)一步闡明。
[Abstract]:Objective: to study the expression of p73 isomer (Np73) in non-melanoma (squamous cell carcinoma, basal cell carcinoma, Bowen's disease, precancerous lesion (sunburn keratosis), benign proliferative disease (psoriasis vulgaris) by immunohistochemical technique. The expression of seborrheic keratosis and normal human skin was compared with that of p53 (all mutant types unless specifically indicated in this paper). To explore the expression and significance of Np73 in non-melanoma of skin, and its practical value in the evaluation of malignant degree and prognosis, as well as the correlation between Np73 and p53 expression in benign and malignant proliferative diseases. Methods: collect and arrange the skin of the Department of Dermatology and Pathology of the first Clinical Hospital of Kunming Medical College. There were 60 cases of poorly differentiated squamous cell carcinoma (SCC) and 20 cases of basal cell carcinoma (BCC), Balwin's disease (BDN), solar keratosis (AKK), psoriasis vulgaris (PSN), seborrheic keratosis (SKK). After the steps of dehydration, embedding, section and staining, Np73 and p53 were stained by immunohistochemical technique. Finally, the difference between the positive cases of each disease and the correlation between Np73 and p53 were analyzed. Results the positive expression rate of protein p53 in all kinds of diseases was significantly higher than that in benign proliferative diseases and normal skin, but the positive rate was higher in SCC BCC BCCBDB and precancerous lesions than in benign proliferative diseases and normal skin. There was no significant difference between the positive rate of SCC BCCBDD) and precancerous lesion (AKK). There was no significant difference in the positive expression of Np73 in all malignant tumors (SCC, BCC, BDD) and precancerous lesion (AKK). The positive expression of Np73 was found in all malignant tumors, including SCC, BCC, BCCBDD) and precancerous lesion (AK). There was no expression of SCC and AK in some benign proliferative venereal diseases (SKK) and normal human skin. The expression rate of SCC and AK was significantly higher than that of other diseases. The difference was statistically significant (P < 0.05), but there was no significant difference between the two groups (P < 0.05). The positive expression rate of Np73 protein and the location of the disease (exposure site and non-exposure site, gender of the patient) were significantly higher than that of the other two groups (P < 0.05), and there was no significant difference between the two groups (P < 0.05). The expression of Np73 and p53 in SCC was positively correlated with the expression of P0. 007, but not in other diseases. Conclusion the positive expression of Np73 has a certain significance in the diagnosis and differential diagnosis of benign and malignant proliferative diseases, but it is less specific in differentiating skin precancerous lesions from non-melanoma, and Np73 has a relatively specific diagnostic value in the diagnosis of SCC / AK. Especially in the differential diagnosis of other diseases, it may have a strong practical value, but has no significant significance for SCC pathological grade, the positive expression rate of Np73 protein has no significant correlation with the age, sex and location of the disease. The expression of Np73 and p53 in SCC is correlated, which indicates that the expression of Np73 and p53 is closely related to the pathogenesis of malignant tumors, and the combination of Np73 and p53 may be of clinical significance in the differential diagnosis of benign and malignant diseases. The complex relationship between Np73 and non-melanoma of skin is still unclear, and more case studies with large sample size and detailed clinical data are needed.
【學(xué)位授予單位】：昆明醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R739.5

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