本文選題：骨肉瘤　切入點：SATB2　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:骨肉瘤的診斷到目前為止一直主要依靠影像學(xué)和組織學(xué)診斷,組織學(xué)上,由于部分不典型骨肉瘤組織中瘤細胞成骨能力較弱,骨樣基質(zhì)形成較少,往往難以與其他肉瘤和瘤樣病變相互區(qū)分鑒別。在臨床病理診斷過程中,常常需要特異性抗體來區(qū)分組織或腫瘤類型。本研究通過應(yīng)用免疫組織化學(xué)方法檢測SATB2在與骨相關(guān)的腫瘤和病變組織中的表達陽性率情況,探討SATB2在診斷骨肉瘤中的價值。方法:本研究篩選出47例骨肉瘤,其中普通型骨肉瘤39例、小細胞性骨肉瘤3例、髓內(nèi)高分化骨肉瘤3例和其它類型骨肉瘤2例。另外篩選出平滑肌肉瘤2例、骨母細胞瘤5例、骨化性肌炎5例、未分化多形性肉瘤5例、纖維結(jié)構(gòu)不良4例、軟骨肉瘤8例、Ewing肉瘤5例、纖維肉瘤6例和軟骨母細胞瘤10例做對比研究。采用免疫組織化學(xué)法檢測并分析SATB2蛋白在這些病變組織中的陽性表達程度。結(jié)果:1、SATB2在骨肉瘤中陽性表達率為83.0%(39/47),根據(jù)WHO分型,可將骨肉瘤細分為普通型骨肉瘤(骨母細胞型、成纖維細胞型、軟骨母細胞型)、小細胞性骨肉瘤、髓內(nèi)高分化骨肉瘤和其他類型骨肉瘤,并分別統(tǒng)計SATB2陽性表達率如下:(1)普通型骨肉瘤:SATB2在骨肉瘤活檢組織中的陽性表達率為84.6%(33/39),其中在骨母細胞型骨肉瘤中陽性表達率為100%(26/26)、成纖維細胞型骨肉瘤中陽性表達率為50%(2/4)、軟骨母細胞型骨肉瘤中陽性表達率為66.7%(2/3);而在瘤段切除的骨母細胞型骨肉瘤中陽性表達率為50%(3/6),顯著低于活檢的骨母細胞型骨肉瘤中陽性表達率;(2)小細胞性骨肉瘤:SATB2在小細胞性骨肉瘤活檢組織中的陽性表達率為100%(3/3);(3)髓內(nèi)高分化骨肉瘤:SATB2在髓內(nèi)高分化骨肉瘤活檢組織中的陽性表達率為33.3%(1/3);(4)其他類型骨肉瘤:SATB2在其他類型骨肉瘤活檢組織中的陽性表達率為100%(2/2);2、骨母細胞瘤:SATB2在骨母細胞瘤中陽性表達率為100%(5/5);3、骨化性肌炎:SATB2在骨化性肌炎中陽性表達率為100%(5/5);4、軟骨母細胞瘤:SATB2在軟骨母細胞瘤中陽性表達率為20.0%(2/10);5、SATB2在纖維結(jié)構(gòu)不良、軟骨肉瘤、Ewing肉瘤和骨原發(fā)性梭形細胞肉瘤(未分化多形性肉瘤、纖維肉瘤和平滑肌肉瘤)中均為陰性表達。結(jié)論:SATB2作為新的成骨細胞標(biāo)記物,在鑒別骨肉瘤和非成骨性惡性腫瘤時是重要的免疫組織化學(xué)補充指標(biāo),但對于區(qū)分骨肉瘤和其它成骨性病變意義有限。
[Abstract]:Objective: up to now, the diagnosis of osteosarcoma mainly depends on imaging and histology. Histologically, the osteogenic ability of tumor cells in some atypical osteosarcoma tissues is weak, and the formation of osteoid matrix is less.It is often difficult to differentiate from other sarcomas and tumor-like lesions.In clinicopathological diagnosis, specific antibodies are often required to distinguish tissue or tumor types.The purpose of this study was to investigate the value of SATB2 in the diagnosis of osteosarcoma by using immunohistochemical method to detect the positive rate of SATB2 expression in osteosarcoma.Methods: 47 cases of osteosarcoma were selected, including 39 cases of common type osteosarcoma, 3 cases of small cell osteosarcoma, 3 cases of intramedullary well-differentiated osteosarcoma and 2 cases of other types of osteosarcoma.In addition, 2 cases of leiomyosarcoma, 5 cases of osteoblastoma, 5 cases of ossifying myositis, 5 cases of undifferentiated pleomorphic sarcoma, 4 cases of fibrous dysplasia, 5 cases of chondrosarcoma and 8 cases of chondrosarcoma were selected.A comparative study was made between 6 cases of fibrosarcoma and 10 cases of chondroblastoma.Immunohistochemical method was used to detect and analyze the positive expression of SATB2 protein in these lesions.Results the positive expression rate of SATB2 in osteosarcoma was 83.0% / 47%. According to WHO classification, osteosarcoma could be subdivided into common type osteosarcoma (osteoblastoma type, fibroblast type, chondroblastoid type, small cell osteosarcoma).Intramedullary highly differentiated osteosarcoma and other types of osteosarcoma,The positive expression rate of SATB2 was 20.0 / 10 / 10 and SATB2 was found in fibrous dysplasia.The expression of Ewing sarcoma and primary spindle cell sarcoma (undifferentiated pleomorphic sarcoma fibrosarcoma and leiomyosarcoma) were negative in chondrosarcoma.Conclusion as a new osteoblast marker, the ratio SATB2 is an important immunohistochemical supplement in differentiating osteosarcoma from non-osteogenic malignant tumor, but it is of limited significance in differentiating osteosarcoma from other osteogenic lesions.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R738.1

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本文編號：1718804