本文關(guān)鍵詞： 喉癌 HPV EGFR 免疫組化　出處：《大連醫(yī)科大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：喉癌是頭頸部常見惡性腫瘤之一，，發(fā)病率僅次于鼻咽癌，是一種多因素致病、多基因參與、多步驟發(fā)展的惡性疾病,占頭頸部腫瘤的13.9%[1]。人類乳頭狀瘤病毒(HPV)屬乳多空DNA病毒，具有嗜上皮性,與多種上皮增生性病變及惡性腫瘤的發(fā)生和發(fā)展有關(guān)，HPV并非喉癌唯一的致病因子，且單獨HPV感染不足以引起人正常鱗狀上皮細胞的惡變，因此推斷HPV感染并發(fā)生惡變還需要其他因子的協(xié)同，來啟動這種病毒的致癌活性從而使得被感染的細胞癌變。近年來發(fā)現(xiàn)EGFR與人類的腫瘤關(guān)系密切，表皮生長因子受體EGFR是一種跨膜糖蛋白，被認為是癌基因,在人體多種惡性腫瘤組織中均過表達，目前以EGFR為靶點的靶向治療已成為熱點。喉癌的形成與HPV感染及EGFR過表達之間是否有一定的關(guān)系？HPV感染對EGFR過表達有何影響？兩者在喉癌的發(fā)病過程中扮演什么角色？針對這些問題，本實驗采用免疫組織化學(xué)法檢測喉癌組織中HPV16/18及EGFR的表達情況,研究HPV16/18感染與EGFR過表達的關(guān)系,以期進一步探討HPV、EGFR與喉癌的臨床病理特征的關(guān)系。 目的：檢測喉癌組織中人乳頭狀瘤病毒HPV與表皮生長因子受體EGFR的表達情況，研究喉癌發(fā)生、發(fā)展的分子生物學(xué)機制，為早期診斷、預(yù)后判斷及分子靶向治療提供客觀參考指標。 方法：收集大連醫(yī)科大學(xué)附屬一院病理科存檔的2003年～2011年間活檢喉癌組織標本63例，據(jù)調(diào)查所有標本均為鱗癌且未經(jīng)放化療。標本經(jīng)甲醛固定,石蠟包埋,組織切片，HE染色、病理證實后用免疫組化二步法測定HPV16/18和EGFR在喉癌組織中的表達情況。應(yīng)用SPSS17.0統(tǒng)計軟件，計數(shù)資料采用χ2檢驗對實驗結(jié)果進行分析，檢驗水準α=0.05，差異顯著性標準為P0.05。 結(jié)果： 1.HPV感染情況:在喉癌組織、喉癌癌旁組織和良性聲帶息肉中，HPV感染率分別為34.92%（22/63）、30.00%（6/20）和5.00%（1/20）。在喉癌組織及癌旁組織中HPV感染率明顯比良性聲帶息肉高（P＜0.05），但喉癌組織與癌旁組織間無明顯相關(guān)性（P＞0.05）。 2.EGFR蛋白表達情況:在喉癌組織、喉癌癌旁組織和良性聲帶息肉組織中，EGFR蛋白陽性表達率分別為77.78%（49/63）、10.00%(2/20)和0.00%(0/20)，喉癌組織顯著高于癌旁及良性聲帶息肉（P＜0.05）。 3.HPV感染與EGFR蛋白表達之間的相互關(guān)系：在喉癌中HPV感染組的EGFR蛋白陽性表達率高于未感染組,兩者差異具統(tǒng)計學(xué)意義(P0.05),HPV蛋白陽性率與EGFR蛋白過表達呈正相關(guān)。 結(jié)論： 1.在喉癌中存在著一定比例的HPV16/18感染，可推測HPV感染與喉癌的發(fā)生發(fā)展有一定的關(guān)系，HPV感染可能是喉癌誘發(fā)的重要原因之一。 2.EGFR的過度表達在喉粘膜的癌變過程中是一個重要的早期指標，可能對喉癌的啟動有重要的作用，喉癌的發(fā)病可能與EGFR過表達相關(guān)。 3.HPV16/18感染與EGFR蛋白的表達呈正相關(guān)，HPV感染引起EGFR過表達可能是喉癌的發(fā)病機制之一。 4.聯(lián)合檢測HPV感染、EGFR蛋白表達情況有助于喉癌的預(yù)警和診斷。
[Abstract]:Laryngeal carcinoma is a common malignant tumor in head and neck, after the incidence of nasopharyngeal carcinoma, is a multifactorial disease, multiple genes, multiple steps of the development of malignant diseases, accounting for head and neck cancer 13.9%[1]. human papilloma virus (HPV) belongs to Papovaviridae DNA virus, with eosinophilic epithelial, occurrence and development with a variety of epithelial hyperplasia lesions and malignant tumors, HPV is not the only pathogenic factor of laryngeal cancer, and HPV infection alone is not sufficient to cause human normal squamous cell malignant tumor, thus infer HPV infection and canceration and coordination also requires other factors, to start the virus so that the carcinogenic activity of cancer cells was found in recent years between infection. EGFR closely with human tumors, epidermal growth factor receptor EGFR is a transmembrane glycoprotein, is considered to be the cancer gene, in tissues of human malignant tumors were over expressed, at EGFR Targeting therapy has become a hot topic. The formation and infection of HPV and EGFR in laryngeal carcinoma whether there is a certain relationship between the expression of HPV? What is the effect of EGFR infection on the expression of the two? What is the role in the pathogenesis of laryngeal cancer? To solve these problems, the immunohistochemical expression of HPV16/18 and EGFR detection laryngeal carcinoma textile chemical method, the infection of HPV16/18 and EGFR expression, to further explore the relationship between HPV, EGFR and clinicopathologic characteristics of laryngeal carcinoma.
Objective: to detect the expression of human papillomavirus HPV and epidermal growth factor receptor EGFR in laryngeal carcinoma tissues, and to study the molecular biological mechanism of laryngeal carcinogenesis and development, so as to provide an objective reference for early diagnosis, prognosis and molecular targeted therapy.
Methods: collect the pathological Department of the First Affiliated Hospital of Dalian Medical University from 2003 to 2011 biopsy specimens of 63 cases of laryngeal carcinoma, according to a survey of all specimens were squamous cell carcinoma and without chemotherapy. Specimens were formalin fixed, paraffin embedded tissue sections, HE staining, pathological expression by immunohistochemical determination of HPV16/18 and EGFR in two steps laryngeal carcinoma confirmed. Using SPSS17.0 statistical software, count data using chi 2 test to analyze the experimental results, a =0.05 level test, difference standard for P0.05.
Result錛

本文編號：1539105