本文選題：膠質(zhì)瘤 + 第二個線粒體衍生的半胱氨酸蛋白酶激活劑��； 參考：《蘭州大學(xué)》2014年碩士論文

【摘要】：目的膠質(zhì)瘤與其它顱內(nèi)腫瘤比較所占比例最高,經(jīng)過外科干預(yù)后仍無法有效的切除干凈,導(dǎo)致術(shù)后容易復(fù)發(fā),預(yù)后差,膠質(zhì)瘤具有著高發(fā)病率、高復(fù)發(fā)率、高病死率和低治愈率的三高一低的特點。本課題旨在通過免疫組化的方法檢測研究半胱氨酸蛋白酶的第二個線粒體激活因子(the second mitochodria-derived activator of caspase, Smac)與X連鎖凋亡抑制蛋白(X-linked inhibitor of apoptosis protein,XIAP)在神經(jīng)膠質(zhì)瘤中的表達情況,分析二者之間的相互作用關(guān)系,研究Smac、XIAP與神經(jīng)膠質(zhì)瘤惡性程度之間的關(guān)系,為能夠準(zhǔn)確的預(yù)判膠質(zhì)瘤的惡性程度和預(yù)后給予一定幫助,并能從凋亡角度考慮腫瘤的發(fā)生。 方法自2011年06月至2013年12月期間在蘭州大學(xué)第二醫(yī)院神經(jīng)外科手術(shù)切除的62例膠質(zhì)瘤標(biāo)本。采用標(biāo)準(zhǔn),根據(jù)WHO(2007年)的分類和分級標(biāo)準(zhǔn)。免疫組織化學(xué)采用鏈霉素抗生物-過氧化物酶法(SP法)檢測,空白對照用磷酸緩沖液代替一抗。Smac與XIAP蛋白陽性表達為細(xì)胞漿中出現(xiàn)棕黃色顆粒。免疫組化結(jié)果計分根據(jù)標(biāo)準(zhǔn)免疫反應(yīng)積分法,觀察陽性細(xì)胞染色深淺并對光學(xué)顯微鏡視野內(nèi)的陽性細(xì)胞進行計數(shù),并計算陽性細(xì)胞數(shù)占細(xì)胞總數(shù)的百分比。(陽性細(xì)胞百分比：未發(fā)現(xiàn)陽性細(xì)胞的為0分(一),陽性細(xì)胞數(shù)占細(xì)胞總數(shù)的10%以下為1分,11～25%為2分,25～50%為3分,50%以上為4分,根據(jù)流行的染色程度(沒有著色是0分,淡黃色是1分,棕黃色是2分,棕褐色是3分)。免疫組化染色評分(免疫組化積分=陽性細(xì)胞百分比PP×染色強度SI)由0-12這13個分級組成,沒有表達(一)是0分,弱陽性表達(+)是1到4分,陽性表達(++)是5到8分,強陽性表達(+++)是9到12分,根據(jù)實驗記錄數(shù)據(jù)用統(tǒng)計軟件SPSS18.0分析兩者的表達情況及與臨床資料的相關(guān)性。 結(jié)果62例人腦膠質(zhì)瘤標(biāo)本中,Smac蛋白在低級別膠質(zhì)瘤和高級別膠質(zhì)瘤中的陽性表達率分別為89.66%,78.79%,差別(P=0.000)具有統(tǒng)計學(xué)意義,與患者病理組織類型、性別及年齡無關(guān)。XIAP蛋白在低級別膠質(zhì)瘤和高級別膠質(zhì)瘤中的陽性表達率分別為79.31%,90.91%,差別(P=0.024)具有統(tǒng)計學(xué)意義,與患者病理組織類型、性別及年齡無關(guān)。在膠質(zhì)瘤中Smac的表達明顯與XIAP的表達呈負(fù)相關(guān)(rs=-0.272,P=0.036)。 結(jié)論1、Smac的表達與膠質(zhì)瘤惡性程度呈負(fù)相關(guān),膠質(zhì)瘤的發(fā)生、發(fā)展可能與其在惡性經(jīng)膠質(zhì)瘤的表達減少和缺失有關(guān)； 2、XIAP的表達與膠質(zhì)瘤惡性程度呈正相關(guān),可能與膠質(zhì)瘤細(xì)胞的惡性增殖密切相關(guān)； 3、人腦膠質(zhì)瘤中Smac的表達與XIAP的表達呈負(fù)相關(guān),二者相互制約； 4、Smac和XIAP的進一步深入研究也許會發(fā)現(xiàn)膠質(zhì)瘤化學(xué)治療的新思路；
[Abstract]:Objective Glioma has the highest proportion compared with other intracranial tumors and can not be resected effectively after surgical intervention, which leads to recurrence easily and poor prognosis. Glioma has a high incidence and high recurrence rate. The characteristics of high mortality and low cure rate are three high and one low. The aim of this study was to investigate the expression of the second mitochondrial activator of cysteine protease (the second mitochodria-derived activator of caspase, SMAC) and X-linked inhibitor of apoptosis protein inhibitor (XIAP) in gliomas by immunohistochemistry. By analyzing the relationship between Smaca XIAP and glioma malignancy degree, it is helpful to predict the malignant degree and prognosis of glioma accurately, and to consider the occurrence of glioma from the angle of apoptosis. Methods from June 2011 to December 2013, 62 cases of gliomas were surgically resected from the second Hospital of Lanzhou University. Adopt standard, according to WHO (2007) classification and classification standard. Immunohistochemistry was used to detect streptomycin anti-biological peroxidase (SP) method. In blank control, phosphoric acid buffer was used instead of the first antibody Smac and XIAP protein to express brown granules in the cytoplasm. According to the standard immunoreactive integration method, the staining depth of positive cells was observed and the number of positive cells in the field of optical microscope was counted, and the percentage of positive cells in the total number of cells was calculated. (percentage of positive cells: no positive cells were found in 0 points (1), the number of positive cells in the total number of cells was less than 10%, 1 minute, 1125%, 2 minutes, 2550%, 3 minutes, 50%, 3 minutes, 50%, 4 points, according to the degree of popular staining (no staining was 0 points, Light yellow is 1, brown is 2, brown is 3). The immunohistochemical staining score (immunohistochemical score = percentage of positive cells PP 脳 staining intensity SI) was composed of 13 grades of 0-12, no expression (1) was 0, weak positive () was 1 to 4, positive expression () was 5 to 8. The strong positive expression was 9 to 12 points. According to the experimental data, SPSS 18.0 was used to analyze the relationship between the expression and clinical data. Results the positive expression rates of SMAC protein were 89.66 and 78.79 in low-grade gliomas and high-grade gliomas, respectively. The difference was statistically significant (P0. 000). The positive expression rates of XIAP protein in low grade glioma and high grade glioma were 79.31 and 90.91respectively. The difference (P0. 024) was statistically significant, but not related to the type of pathological tissue, sex and age. The expression of SMAC in gliomas was negatively correlated with the expression of XIAP (rs-0.272). Conclusion 1 the expression of Smac is negatively correlated with the degree of malignancy of gliomas, the occurrence and development of gliomas may be related to the decrease and deletion of SMAC expression in malignant gliomas, and the expression of XIAP in gliomas is positively correlated with the degree of malignancy of gliomas. (3) the expression of SMAC and XIAP in human glioma is negatively correlated with the expression of XIAP, and they restrict each other. 4the further study of Smac and XIAP may find a new way of chemotherapy for glioma.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R739.41

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