本文關(guān)鍵詞：中國(guó)鼻咽癌患者放射敏感性的蛋白標(biāo)志物：meta分析　出處：《吉林大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 鼻咽癌 放射治療 蛋白標(biāo)志物 meta分析

【摘要】：背景：我國(guó)鼻咽癌發(fā)病率占世界80%左右，尤其廣東、廣西等華南地區(qū)，，鼻咽癌死亡率占全部惡性腫瘤死亡率的2.81%，居第八位。放療是目前治療鼻咽癌的首要手段，局部復(fù)發(fā)和遠(yuǎn)處轉(zhuǎn)移是治療失敗的主要原因。放射治療效果考慮與腫瘤內(nèi)在放射敏感性相關(guān)，放射敏感性理論上與細(xì)胞周期調(diào)控、DNA損傷修復(fù)、細(xì)胞凋亡及增殖、乏氧與血管生成等蛋白相關(guān)，但是目前尚缺乏快速、靈敏、準(zhǔn)確預(yù)測(cè)腫瘤放射敏感性的蛋白標(biāo)志物。關(guān)于鼻咽癌放療敏感性與蛋白標(biāo)志物的臨床研究結(jié)果不一致，目前尚無(wú)鼻咽癌放射敏感性與蛋白標(biāo)志物的meta分析。 方法：檢索1977年-2013年3月Pubmed、CNKI電子數(shù)據(jù)庫(kù)查找文獻(xiàn)，并通過(guò)對(duì)已納文獻(xiàn)的參考文獻(xiàn)手工追溯查找遺漏的相關(guān)文獻(xiàn)。文獻(xiàn)納入標(biāo)準(zhǔn)：⑴研究對(duì)象:①初治患者；②種族為中國(guó)人；③病理診斷為鼻咽鱗癌；⑵干預(yù)措施：根治性放射治療，且近期療效評(píng)估前未進(jìn)行化療或其它治療；⑶有明確療效指標(biāo)；⑷排除綜述性、重復(fù)發(fā)表及數(shù)據(jù)不全的研究。 結(jié)果：共納入96篇文獻(xiàn)，近期療效指標(biāo)多為腫瘤完全緩解率，遠(yuǎn)期療效指標(biāo)多為5年總生存率，涉及12種蛋白，其中僅對(duì)研究數(shù)目較多的近期、遠(yuǎn)期療效指標(biāo)均有的5種蛋白（p53、Cyclin D1、PCNA、Ki-67、Survivin）進(jìn)行meta分析。p53高表達(dá)的鼻咽癌患者根治性放療后腫瘤完全緩解率低（OR=0.672（95%CI：0.455~0.992），P=0.046），5年總生存率低（OR=2.488（94%CI：1.749~3.539），P=0.000）；Cyclin D1表達(dá)水平與鼻咽癌放療后腫瘤完全緩解率無(wú)相關(guān)性（OR=0.575（95%CI：0.085~3.882），P=0.570），但其高表達(dá)的鼻咽癌患者放療后5年總生存率低（OR=3.950（94%CI：1.638~9.524），P=0.002）；PCNA高表達(dá)的鼻咽癌患者根治性放療后腫瘤完全緩解率低（OR=0.347（95%CI：0.212~0.566），P=0.000），5年總生存率低（OR=2.564（95%CI：1.176~5.591），P=0.018）；Ki-67高表達(dá)的鼻咽癌患者根治性放療后腫瘤完全緩解率高（OR=5.597（95%CI：3.276~9.561），P=0.000），5年總生存率低（OR=2.747（95%CI：1.592~4.740），P=0.000）；Survivin高表達(dá)的鼻咽癌患者根治性放療后腫瘤完全緩解率低（OR=0.208（95%CI：0.112~0.386），P=0.000），5年總生存率低（OR=2.709（95%CI：1.974~3.716），P=0.000）。 結(jié)論：p53、PCNA、Survivin高表達(dá)的鼻咽癌患者放療后腫瘤完全緩解率低，5年總生存率低。Ki-67高表達(dá)者放療后腫瘤完全緩解率高，但5年總生存率低。鼻咽癌患者放射治療前聯(lián)合檢測(cè)蛋白標(biāo)志物可以實(shí)現(xiàn)個(gè)體化放射治療，但需要高質(zhì)量、大樣本的病例對(duì)照研究證實(shí)，特別是前瞻性隨機(jī)對(duì)照研究。
[Abstract]:Background: the incidence of nasopharyngeal carcinoma (NPC) in China accounts for about 80% in the world, especially in Guangdong, Guangxi and South China. The mortality rate of NPC accounts for 2.81% of the total mortality of malignant tumors. Radiotherapy is the most important method in the treatment of nasopharyngeal carcinoma. Local recurrence and distant metastasis are the main causes of failure. The effect of radiotherapy is related to the internal radiosensitivity of the tumor. Radiosensitivity is theoretically related to cell cycle regulation of DNA damage repair, cell apoptosis and proliferation, hypoxia and angiogenesis, etc. The results of clinical studies on radiosensitivity and protein markers of nasopharyngeal carcinoma (NPC) were not consistent. There is no meta analysis of radiosensitivity and protein markers in nasopharyngeal carcinoma. Methods: search the electronic database of Pubmedus from 1977 to March 2013. And through the manual tracing the missing related literature to the reference document of the accepted literature, the literature was included in the standard of "1: 1" study object: 1 newly treated patient; (2) ethnic group is Chinese; 3pathological diagnosis of nasopharyngeal squamous cell carcinoma; 2Interventional measures: radical radiotherapy, and no chemotherapy or other treatment before the evaluation of short-term curative effect; 3There are definite curative effect indexes; (4) exclude the research of summarization, duplicate publication and incomplete data. Results: a total of 96 articles were included. Most of the short-term efficacy indicators were complete remission rate of tumor, and the long-term curative effect index was 5-year overall survival rate, involving 12 kinds of proteins, among which, only for the short term with a large number of studies. There were 5 kinds of protein p53 Cyclin D1 and PCNAfi-67 in all the long-term curative effect indexes. Meta analysis with survivin. P53 overexpression in patients with nasopharyngeal carcinoma (NPC) after radical radiotherapy, the complete remission rate was low and OR0.672 (. 95CI: 0.4550.992. The 5-year overall survival rate was 2.488 / 94 CI: 1.749 ~ 3.539%, P = 0.000 ~ 0.000; There was no correlation between the expression of Cyclin D1 and the complete remission rate of nasopharyngeal carcinoma after radiotherapy. However, the 5-year overall survival rate of NPC patients with high expression after radiotherapy was low. The complete remission rate of nasopharyngeal carcinoma patients with high expression of PCNA after radical radiotherapy was low. The 5-year overall survival rate was lower than that of 2.564 / 95 CI: 1.176 / 5.591/ P0.018; The complete remission rate of nasopharyngeal carcinoma (NPC) patients with high expression of Ki-67 was 5.597% and 0.000 respectively after radical radiotherapy. The overall 5-year overall survival rate was 2.747 ~ 95% CI: 1.592 ~ 4.740% ~ 0.000 ~ 0.000; The complete remission rate of nasopharyngeal carcinoma (NPC) patients with high expression of Survivin was 0.208% and 0.208% respectively after radical radiotherapy. The overall 5-year overall survival rate was 2.709 / 95% CI: 1.974 / 3.716 / P = 0.000. Conclusion the complete remission rate of nasopharyngeal carcinoma patients with high expression of survivin is low after radiotherapy. The overall 5-year survival rate was low in patients with high expression of Ki-67, but the complete remission rate was higher after radiotherapy, but the 5-year overall survival rate was low. Combined detection of protein markers before radiotherapy in patients with nasopharyngeal carcinoma could realize individualized radiotherapy. But high-quality, large-sample case-control studies are needed, especially prospective randomized controlled trials.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R739.63

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 葉偉軍;閔華慶;曹新平;陳昆田;侯景輝;李楊;;P53蛋白、血管內(nèi)皮生長(zhǎng)因子等生物分子指標(biāo)與鼻咽癌放射敏感性的關(guān)系[J];癌癥;2006年09期

2 鄒繼彬,黃廣恩,陳中堅(jiān),陳鴻蓮;Survivin蛋白和PCNA在鼻咽癌中的表達(dá)及其臨床意義[J];中國(guó)醫(yī)師雜志;2004年12期

3 吳又明,儲(chǔ)兵;nm23,p53,PCNA的表達(dá)與鼻咽癌轉(zhuǎn)移預(yù)后的關(guān)系[J];廣東醫(yī)學(xué);2000年05期

4 劉文清,陳志仁,李靜,劉緒光,李烈,廖土明,邱俊勇;cyclinD1和p16蛋白在鼻咽低分化鱗癌表達(dá)與預(yù)后的關(guān)系[J];廣東醫(yī)學(xué);2001年11期

5 吳仁瑞,邱萬(wàn)茂,鐘豪;P~(53)過(guò)量表達(dá)與鼻咽癌放療近期療效的關(guān)系[J];贛南醫(yī)學(xué)院學(xué)報(bào);2000年04期

6 南楠;張維元;;c-myc、P21~(WAF1)和LMP-1在鼻咽癌中表達(dá)的意義及其與Ki67的關(guān)系[J];貴陽(yáng)醫(yī)學(xué)院學(xué)報(bào);2006年01期

7 鐘偉銘;馬麗萍;蔡永林;梁偉;陳萬(wàn)生;黃卓;于紅;譚碧芳;;p53蛋白表達(dá)與鼻咽癌放射敏感性關(guān)系的研究[J];廣西醫(yī)學(xué);2009年04期

8 張少偉,林連興,沈金輝,江遠(yuǎn)仕,陳恩河,施清仕;nm23與PCNA蛋白在鼻咽癌中的表達(dá)及臨床意義[J];河南腫瘤學(xué)雜志;2001年02期

9 郭小青,鐘豪,肖震宇;P53蛋白高表達(dá)與鼻咽癌放療遠(yuǎn)期療效關(guān)系的研究[J];臨床腫瘤學(xué)雜志;2005年05期

10 劉穎新;朱小東;葛蓮英;王安宇;陳龍;陳發(fā)龍;羅元;;PCNA和PTEN的表達(dá)水平在鼻咽癌預(yù)后判斷中的意義[J];臨床腫瘤學(xué)雜志;2006年10期

相關(guān)碩士學(xué)位論文 前3條

1 黃闐;鼻咽癌細(xì)胞增殖凋亡與放射敏感性相關(guān)關(guān)系的研究[D];汕頭大學(xué);2004年

2 鐘曉鳴;鼻咽癌中自發(fā)凋亡及相關(guān)基因表達(dá)與放射敏感性的實(shí)驗(yàn)研究[D];江西醫(yī)學(xué)院;2005年

3 唐衛(wèi)軍;84例鼻咽癌組織中p53表達(dá)與預(yù)后的關(guān)系[D];重慶醫(yī)科大學(xué);2008年

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