本文選題：乳房外Paget病 + PDCD4�。� 參考：《河北醫(yī)科大學》2017年碩士論文

【摘要】：目的:乳房外Paget病(Extramammary Paget’s disease EMPD)于1989年由Crocker首次報道,是一種相對少見的皮膚惡性腫瘤,其組織學來源仍存在爭議,本病好發(fā)于老年人,常見于肛門、外生殖器區(qū)域,皮損呈濕疹樣外觀,組織病理可見Paget細胞。腫瘤的形成往往伴有抑癌基因的失活和癌基因的表達上調(diào);而炎癥與腫瘤的關(guān)系也越來越受到重視,炎癥反應(yīng)可改變病變部位的微環(huán)境、增加細胞突變的概率,促使腫瘤的發(fā)生。NF-κB、Nrf2信號通路不但在氧化應(yīng)激與炎性反應(yīng)中扮演著重要角色,在一些惡性腫瘤中,也發(fā)現(xiàn)有NF-κB、Nrf2的表達。該實驗通過免疫組織化學的方法,檢測抑癌基因PDCD4、癌基因Survivin及NF-κB、Nrf2在EMPD皮損及正常組織中的表達情況,探討PDCD4、Survivin、NF-κB及Nrf2在EMPD發(fā)生、發(fā)展中的作用。方法:選取滄州市中心醫(yī)院皮膚科2000年1月-2014年5月間經(jīng)病理證實的EMPD組織30例,另選取腋窩處正常組織20例為對照組,采用免疫組化技術(shù),綜合統(tǒng)計染色強度及染色陽性率,運用SPSS17.0統(tǒng)計軟件處理數(shù)據(jù),比較病變組織及正常組織中PDCD4、Survivin、NF-κB及Nrf2的陽性表達率之間的差異,采用χ2檢驗,把具有統(tǒng)計學意義顯著性差異的臨界值設(shè)定為P0.05。PDCD4、Survivin、NF-κB及Nrf2相關(guān)性采用Pearson相關(guān)分析。結(jié)果:1 PDCD4在EMPD組織中陽性率為23.3%,在正常組織中陽性率為100%,兩者相比較,有顯著差異(P0.05),Survivin在EMPD組織中的陽性率為80%,在正常組織中未見表達,兩者相比較,有顯著差異(P0.05),NF-κB在EMPD組織中的陽性率為70%,在正常組織中未見表達,兩者相比較,有顯著差異(P0.05),Nrf2在EMPD組織中的陽性率為73.3%,在正常組織中的陽性率是10%,兩者相比較,有顯著差異(P0.05)。2 NF-κB在Survivin陽性和陰性患者中的陽性率分別是83.3%和33.3%,兩者間差異有統(tǒng)計學意義(r=0.452,P=0.013),Nrf2在Survivin陽性和陰性患者中的陽性率分別是79.2%和33.3%,兩者間差異有統(tǒng)計學意義(r=0.4,P=0.028)。3 PDCD4在Survivin陽性和陰性患者中的陽性率分別是12.1%和66.7%,兩者間差異有統(tǒng)計學意義(r=-0.512,P=0.005),PDCD4在NF-κB陽性和陰性患者中的陽性率分別是4.8%和66.7%,兩者間差異有統(tǒng)計學意義(r=-0.671,P=0.001),PDCD4在Nrf2陽性和陰性患者中的陽性率分別是9.1%和62.5%,兩者間差異有統(tǒng)計學意義(r=-0.588,P=0.002)。結(jié)論:1 PDCD4蛋白在乳房外Paget病組織中的表達明顯低于在正常組織中的表達。2 Survivin、NF-κB和Nrf2蛋白在乳房外Paget病組織中的表達明顯高于在正常組織中的表達。3 Survivin蛋白與NF-κB、Nrf2蛋白在乳房外Paget病組織中的表達呈正相關(guān)。4 PDCD4蛋白與Survivin、NF-κB、Nrf2蛋白在乳房外Paget病組織中的表達呈負相關(guān)。5抑癌基因PDCD4、癌基因Survivin與NF-κB、Nrf2參與了乳房外Paget病的發(fā)生、發(fā)展,并表明,炎癥反應(yīng)可能在乳房外Paget病形成過程中有重要的作用。6 Survivin、NF-κB及Nrf2蛋白可聯(lián)合作為免疫組化指標,輔助乳房外Paget病的診斷,并且可以協(xié)助明確手術(shù)后切緣情況。
[Abstract]:Objective: Extramammary Paget 's disease EMPD (Paget' s disease EMPD) was first reported by Crocker in 1989. It is a relatively rare malignant tumor of the skin. Its histological origin is still controversial. This disease occurs in the elderly, common in the anus, the external genitals area, the skin lesions are eczema like appearance, histopathologically, Paget cells. Tumor shape is seen. The inactivation of the tumor suppressor gene and the up-regulated expression of the oncogene are often up-regulated, and the relationship between inflammation and tumor is becoming more and more important. The inflammatory response can change the microenvironment of the lesion, increase the probability of cell mutation and promote the occurrence of.NF- kappa B in the tumor, and the Nrf2 signaling pathway not only plays an important role in oxidative stress and inflammatory response, but also plays an important role in oxidative stress and inflammatory response. In some malignant tumors, the expression of NF- kappa B, Nrf2 was also found. This experiment was used to detect the expression of tumor suppressor gene PDCD4, Survivin and NF- kappa B, Nrf2 in EMPD skin lesions and normal tissues by immunohistochemistry. The role of PDCD4, Survivin, NF- kappa, and development was explored. Methods: Cangzhou city center medicine 30 cases of EMPD, which were confirmed by pathology in the hospital department of Dermatology, January 2000 -2014 years, and 20 cases of normal tissue at the axilla were selected as the control group. The immunohistochemical technique was used to calculate the staining intensity and positive rate of dyeing. The data were processed by SPSS17.0 statistics software to compare the positive of PDCD4, Survivin, NF- kappa B and Nrf2 in the pathological and normal tissues. The difference between the sex expression rate, using the chi 2 test, set the critical value of statistically significant difference to P0.05.PDCD4, Survivin, NF- kappa B and Nrf2 correlation using Pearson correlation analysis. Results: the positive rate of 1 PDCD4 in EMPD tissue was 23.3%, and the Zhongyang sex rate in normal tissues was 100%, and there were significant differences (P0.05), Surv, Surv. The positive rate of ivin in EMPD tissues was 80%, and there was no expression in normal tissues. There were significant differences (P0.05). The positive rate of NF- kappa B in EMPD tissues was 70%, and there was no expression in normal tissues. There was a significant difference between the two groups (P0.05), the positive rate of Nrf2 in EMPD tissues was 73.3%, and the positive rate in normal tissues was 10%, The positive rates of P0.05.2 NF- kappa B in Survivin positive and negative patients were 83.3% and 33.3%, respectively, and the difference between them was statistically significant (r=0.452, P=0.013). The positive rates of Nrf2 in the positive and negative patients were 79.2% and 33.3%, respectively, and there was a significant difference between the two (r=0.4, P=0.028).3. The positive rates in Survivin positive and negative patients were 12.1% and 66.7%, respectively, and the differences were statistically significant (r=-0.512, P=0.005). The positive rates of PDCD4 in NF- kappa B positive and negative patients were 4.8% and 66.7% respectively (r=-0.671, P= 0.001), and the positive rates of PDCD4 in Nrf2 positive and negative patients were statistically significant. The difference between 9.1% and 62.5% was statistically significant (r=-0.588, P=0.002). Conclusion: the expression of 1 PDCD4 protein in external Paget disease was significantly lower than that in normal tissue, and the expression of NF- kappa B and Nrf2 protein in the external mammary Paget disease was significantly higher than that in normal tissues. The expression of kappa B, Nrf2 protein in Paget disease tissues is positively related to the.4 PDCD4 protein and Survivin, NF- kappa B, and the expression of Nrf2 protein in the external mammary Paget disease is negatively related to the.5 tumor suppressor gene PDCD4, and the oncogene is involved in the occurrence and development of the external mammary gland disease. There is an important role in the formation of.6 Survivin, NF- kappa B and Nrf2 protein can be combined as an immunohistochemical marker, assisting the diagnosis of Paget disease outside the breast, and can help to clarify the postoperative margin of the resection.

【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R739.5

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本文編號：1859902