本文選題：基質(zhì)細胞衍生因子1 + 基質(zhì)金屬蛋白酶9��； 參考：《西南醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:許多惡性腫瘤細胞均能分泌趨化因子,其與腫瘤細胞相互作用,關(guān)于趨化因子的研究已成為腫瘤研究的熱點領(lǐng)域之一;基質(zhì)細胞衍生因子是一類具有趨化作用的小分子蛋白,在腫瘤的發(fā)生、發(fā)展、分化和轉(zhuǎn)移中起著重要作用�；|(zhì)金屬蛋白酶是一組具有蛋白水解功能的含鋅蛋白水解酶大家族,在組織正常的重塑和修復(fù)過程中負責(zé)降解胞外基質(zhì)成分,其過度或不恰當?shù)谋磉_是導(dǎo)致癌組織侵襲和轉(zhuǎn)移的重要機制。本文通過檢測基質(zhì)細胞衍生因子1(stromal cell-derived factor-1,SDF-1)和基質(zhì)金屬基質(zhì)蛋白酶9(matrix metalloproteinase-9,MMP-9)在喉鱗癌中的表達,分析探討SDF-1和MMP-9在喉鱗癌組織中表達的作用和臨床意義。方法:回顧性選取內(nèi)江市第一人民醫(yī)院耳鼻咽喉頭頸外科2006年2月-2011年2月手術(shù)切除且資料完整的喉癌石蠟包埋標本42例,另取同期19例癌旁陰性喉黏膜組織作為對照,隨訪喉癌患者腫瘤的復(fù)發(fā)及生存情況,收集整理患者臨床、病理資料;應(yīng)用免疫組織化學(xué)SP法檢測42例喉癌組織及19例癌旁陰性喉黏膜組織中SDF-1和MMP-9的表達,結(jié)合患者年齡、性別、病程、病理分化程度、TNM分期、臨床分期、隨訪結(jié)果等臨床資料,分析SDF-1和MMP-9的表達與喉鱗癌患者臨床病理特征及預(yù)后之間的關(guān)系。結(jié)果:(1)喉癌組織中SDF-1陽性表達率為52.4%,高于癌旁陰性喉黏膜組織中的陽性率21.1%(x~2=5.250,P=0.022);MMP-9在喉鱗癌組織中陽性表達率為59.5%,高于癌旁陰性喉黏膜組織中的陽性表達率26.3%(x~2=5.772,P=0.016);(2)不同年齡、性別、病程及有無吸煙嗜好患者喉鱗癌組織中SDF-1及MMP-9表達差異均無統(tǒng)計學(xué)意義(P均0.05);(3)T_(1-2)期喉鱗癌組織中SDF-1陽性表達率為38.7%,低于T_(3-4)期陽性表達率90.9%(x~2=8.869,P=0.003);T_(1-2)期喉鱗癌組織中MMP-9陽性表達率41.9%,T_(3-4)期陽性率81.8%,兩者差異比較有統(tǒng)計學(xué)意義(x~2=5.177,p=0.023);(4)n0期患者sdf-1陽性表達率33.3%,低于n1-3期患者表達陽性率100.0%(x~2=15.273,p=0.000);未發(fā)生轉(zhuǎn)移者(n0)mmp-9陽性率43.3%,低于發(fā)生轉(zhuǎn)移者(n1-3)陽性率83.3%(x~2=5.536,p=0.019);(5)臨床分期Ⅰ-Ⅱ期患者sdf-1陽性表達率為30.0%,低于Ⅲ-Ⅳ期陽性表達率72.7%(x~2=7.668,p=0.006);臨床分期Ⅰ-Ⅱ期患者mmp-9陽性率40.0%,Ⅲ-Ⅳ期陽性率72.7%,差異比較有統(tǒng)計意義(x~2=4.582,p=0.032);(6)高分化喉鱗癌組織中sdf-1陽性率43.5%,中低分化喉鱗癌組織中sdf-1陽性率為63.2%,兩者差異無統(tǒng)計學(xué)意義(x~2=1.616,p=0.204);高分化喉鱗癌患者中mmp-9表達陽性率34.8%,低于中低分化患者的陽性率78.9%,(x~2=8.192,p=0.004);(7)聲門型喉鱗癌中sdf-1陽性陽性率41.2%,非聲門型喉癌中陽性率62.5%,兩者比較差異無統(tǒng)計學(xué)意義(x~2=0.484,p=0.487);聲門型喉鱗癌中mmp-9的陽性表達率為47.1%,非聲門型喉癌中陽性率87.5%,差異無統(tǒng)計學(xué)意義(x~2=2.799,p=0.094);(8)喉鱗癌患者中sdf-1與mmp-9表達同為陽性17例,同為陰性12例;相關(guān)系數(shù)r=0.379,p=0.014,即sdf-1與mmp-9在喉癌組織中的表達成正相關(guān)關(guān)系;(9)sdf-1表達陽性患者的總生存率45.0%與表達陰性患者的總生存率81.8%比較差異統(tǒng)計學(xué)意義(x~2=4.334,p=0.037),sdf-1表達陽性患者的無瘤生存率61.1%與表達陰性患者的無瘤生存率85.7%比較差異有統(tǒng)計學(xué)意義(x~2=5.901,p=0.015);mmp-9表達陽性患者的總生存率36.8%低于表達陰性患者的總生存率82.6%(x~2=4.023,p=0.045),mmp-9表達陽性患者的無瘤生存率56.2%低于表達陰性患者的無瘤生存率87.5%(x~2=3.880,p=0.048);(10)經(jīng)cox風(fēng)險回歸模型分析,喉鱗癌組織中sdf-1與mmp-9表達均不是影響患者預(yù)后的獨立危險因素。結(jié)論:(1)sdf-1在喉鱗癌組織中高表達,但與病理分化程度不相關(guān),提示其與喉癌的發(fā)生有關(guān);mmp-9在喉癌組織中高表達,且中低分化組織中表達率更高,提示其與喉鱗癌的發(fā)生及惡性分化有關(guān);(2)喉鱗癌組織中SDF-1和MMP-9表達與患者的年齡、性別、吸煙嗜好、病程無關(guān);(3)喉鱗癌組織中SDF-1和MMP-9表達與T分期和臨床分期呈負相關(guān),提示兩可能與喉癌的進展有關(guān);(4)有頸部淋巴結(jié)轉(zhuǎn)移患者的喉鱗癌組織中SDF-1與MMP-9表達率較高,提示兩者與頸部淋巴結(jié)轉(zhuǎn)移相關(guān);(5)喉鱗癌組織中SDF-1和MMP-9表達與喉癌的臨床分型無關(guān);(6)SDF-1和MMP-9兩者在喉鱗癌中的表達呈正相關(guān)性,預(yù)示兩者在參與喉癌的發(fā)生、發(fā)展中可能具有協(xié)同作用;(7)喉鱗癌組織中SDF-1與MMP-9的表達與喉癌患者無瘤生存率及總生存率呈負相關(guān);(8)喉鱗癌組織中SDF-1和MMP-9表達在喉癌患者預(yù)后評估中的價值有待進一步研究。
[Abstract]:Objective: many malignant tumor cells can secrete chemokines, which interact with tumor cells, study on chemokines has become one of the hot fields of cancer research; stromal cell derived factor is a class of small molecule protein chemotaxis, development in tumorigenesis, differentiation and plays an important role transfer. MMPs are a group of proteolytic function of zinc containing protein hydrolase family, is responsible for the degradation of extracellular matrix components in normaltissue remodeling and repair process, the excessive or inappropriate expression may be an important mechanism of invasion and metastasis of carcinoma. The detection of stromal cell derived factor 1 (stromal cell-derived factor-1, SDF-1) matrix and matrix metalloproteinase 9 (matrix metalloproteinase-9 MMP-9) expression in laryngeal squamous cell carcinoma, analysis of SDF-1 and MMP-9 in laryngeal squamous cell carcinoma table The role and clinical significance. Methods: retrospective selection of Neijiang city first people's Hospital of Otolaryngology Head and neck surgery, February 2006 -2011 year in February and complete surgical resection of laryngeal carcinoma paraffin embedded specimens of 42 cases, the other to take over the same period 19 cases of adjacent negative laryngeal mucosa as control, recurrence and survival of tumor patients with laryngeal carcinoma. Collect the clinical and pathological data; the expression of SDF-1 and MMP-9 immunohistochemistry was applied to detect the SP method in 42 cases of laryngeal carcinoma tissues and 19 cases of adjacent negative laryngeal mucosa, combined with patient's age, gender, disease duration, pathological differentiation, TNM stage, clinical stage, clinical data and follow-up results, analysis of the relationship between SDF-1 and the expression of MMP-9 in laryngeal squamous cell carcinoma and clinicopathological features and prognosis. Results: (1) the positive expression rate of SDF-1 was 52.4% in laryngeal carcinoma, paracancerous negative laryngeal mucosa in 21.1% (the positive rate of x~2=5.25 0,P=0.022);MMP-9鍦ㄥ枆槌炵檶緇勭粐涓槼鎬ц〃杈劇巼涓，

本文編號：1738032