【摘要】：【目的】探討鼻咽癌中CD3、CD45RO的表達及其臨床意義，為鼻咽癌的預后評估提供新的方法，及為其細胞免疫治療提供理論依據。 【方法】收集2012年1月至2013年1月間在蘇州大學附屬第一醫(yī)院耳鼻咽喉科門診喉鏡下鼻咽部活檢并經病理檢查確診為鼻咽癌的活檢組織46例和非腫瘤性鼻咽部活檢組織46例，所有腫瘤性和非腫瘤性標本均經10%甲醛固定，石蠟包埋切片，采用HE染色方法、免疫組織化學檢測CD3和CD45RO的陽性表達水平。分析兩種蛋白與鼻咽癌的臨床病理特征之間的關系，以及兩種蛋白相互之間的關系。 【結果】（1）CD3在非腫瘤性鼻咽粘膜組織及鼻咽癌中的陽性表達率分別為69.57%、84.78%，在46例鼻咽癌病例中，CD3的表達水平與頸部淋巴結轉移呈負相關（r=-0.484,P0.05），，與病理分化程度呈負相關（r=-0.33,P0.05），而與年齡、性別無明顯相關性。（2）CD45RO在非腫瘤性鼻咽粘膜組織及鼻咽癌中的陽性表達率分別為91.30%、86.96%。在46例鼻咽癌病例中，CD45RO的表達水平與頸部淋巴結轉移呈負相關（r=-0.294,P0.05），與性別亦有相關性（P0.05），與病理分化程度、年齡無明顯相關性。（3）CD3和CD45RO表達之間有統(tǒng)計學意義（P0.05）。 【結論】（1）CD3在鼻咽癌組織中的表達水平高于非腫瘤性鼻咽粘膜組織中的表達，CD45RO在鼻咽癌組織中的表達水平低于非腫瘤性鼻咽粘膜組織中的表達。（2）鼻咽癌組織的病理分化程度越低，CD3的陽性表達率越高。（3）CD3、CD45RO在鼻咽癌組織中高水平表達可能減少頸部淋巴結轉移，CD3、CD45RO的表達水平較高者發(fā)生頸部淋巴結轉移較少，而腫瘤的有無轉移與其預后是密切相關的，從而推測此類患者預后相對較好。（4）CD3、CD45RO在抗瘤過程中可能有相關性。（5）與傳統(tǒng)UICC—TNM組織學分級評估預后不同，通過對CD3、CD45RO的檢測研究可以從另外一個層面評估鼻咽癌的預后情況，并為其細胞免疫治療提供理論依據。
[Abstract]:[objective] to investigate the expression and clinical significance of CD3pCD45RO in nasopharyngeal carcinoma (NPC), and to provide a new method for prognosis evaluation of nasopharyngeal carcinoma (NPC). [methods] from January 2012 to January 2013, biopsy of nasopharynx was performed under laryngoscope and confirmed by pathological examination in the department of otolaryngology and otolaryngology, first affiliated Hospital of Suzhou University. 46 cases of nasopharyngeal carcinoma and 46 cases of non-neoplastic nasopharyngeal biopsy were studied. All tumor and non-tumor specimens were fixed with 10% formaldehyde and embedded in paraffin sections. The positive expression of CD3 and CD45RO was detected by HE staining and immunohistochemistry. To analyze the relationship between the two proteins and the clinicopathological features of nasopharyngeal carcinoma, [results] (1) the positive expression rates of CD3 in non-neoplastic nasopharyngeal mucosa and nasopharyngeal carcinoma were 69.57 and 84.78, respectively. In 46 cases of nasopharyngeal carcinoma, the expression level of CD3 and cervical lymph nodes were detected. There was a negative correlation between metastasis and pathological differentiation (P 0.05), but a negative correlation between metastasis and age (P 0.05). (2) the positive expression rates of CD45RO in nonneoplastic nasopharyngeal mucosa and nasopharyngeal carcinoma were 91.30 and 86.96, respectively. In 46 cases of nasopharyngeal carcinoma, the expression of CD45RO was negatively correlated with cervical lymph node metastasis (r-0.294), and correlated with sex (P0.05), and with the degree of pathological differentiation. (3) there was significant difference between the expression of CD3 and CD45RO (P0.05). [conclusion] (1) the expression of CD3 in nasopharyngeal carcinoma is higher than that in non-neoplastic nasopharyngeal mucosa. (2) the lower the pathological differentiation of nasopharyngeal carcinoma, the higher the positive expression rate of CD3. (3) the high level of CD3pCD45RO expression in nasopharyngeal carcinoma may reduce the expression of CD3nc-CD45RO in cervical lymph node metastasis. The cervical lymph node metastasis was less in the patients with higher level. However, metastasis is closely related to the prognosis of the tumor, which suggests that the prognosis of these patients is relatively good. (4) CD3+ CD45RO may be related to the anti-tumor process. (5) it is different from the traditional UICC-TNM histological grading in the evaluation of prognosis. Through the detection of CD3 and CD45RO, we can evaluate the prognosis of nasopharyngeal carcinoma on another level, and provide the theoretical basis for the cellular immunotherapy of nasopharyngeal carcinoma.
【學位授予單位】：蘇州大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R739.63

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