【摘要】：【目的】探討鼻咽癌中CD3、CD45RO的表達(dá)及其臨床意義，為鼻咽癌的預(yù)后評(píng)估提供新的方法，及為其細(xì)胞免疫治療提供理論依據(jù)。 【方法】收集2012年1月至2013年1月間在蘇州大學(xué)附屬第一醫(yī)院耳鼻咽喉科門(mén)診喉鏡下鼻咽部活檢并經(jīng)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(biāo)本均經(jīng)10%甲醛固定，石蠟包埋切片，采用HE染色方法、免疫組織化學(xué)檢測(cè)CD3和CD45RO的陽(yáng)性表達(dá)水平。分析兩種蛋白與鼻咽癌的臨床病理特征之間的關(guān)系，以及兩種蛋白相互之間的關(guān)系。 【結(jié)果】（1）CD3在非腫瘤性鼻咽粘膜組織及鼻咽癌中的陽(yáng)性表達(dá)率分別為69.57%、84.78%，在46例鼻咽癌病例中，CD3的表達(dá)水平與頸部淋巴結(jié)轉(zhuǎn)移呈負(fù)相關(guān)（r=-0.484,P0.05），，與病理分化程度呈負(fù)相關(guān)（r=-0.33,P0.05），而與年齡、性別無(wú)明顯相關(guān)性。（2）CD45RO在非腫瘤性鼻咽粘膜組織及鼻咽癌中的陽(yáng)性表達(dá)率分別為91.30%、86.96%。在46例鼻咽癌病例中，CD45RO的表達(dá)水平與頸部淋巴結(jié)轉(zhuǎn)移呈負(fù)相關(guān)（r=-0.294,P0.05），與性別亦有相關(guān)性（P0.05），與病理分化程度、年齡無(wú)明顯相關(guān)性。（3）CD3和CD45RO表達(dá)之間有統(tǒng)計(jì)學(xué)意義（P0.05）。 【結(jié)論】（1）CD3在鼻咽癌組織中的表達(dá)水平高于非腫瘤性鼻咽粘膜組織中的表達(dá)，CD45RO在鼻咽癌組織中的表達(dá)水平低于非腫瘤性鼻咽粘膜組織中的表達(dá)。（2）鼻咽癌組織的病理分化程度越低，CD3的陽(yáng)性表達(dá)率越高。（3）CD3、CD45RO在鼻咽癌組織中高水平表達(dá)可能減少頸部淋巴結(jié)轉(zhuǎn)移，CD3、CD45RO的表達(dá)水平較高者發(fā)生頸部淋巴結(jié)轉(zhuǎn)移較少，而腫瘤的有無(wú)轉(zhuǎn)移與其預(yù)后是密切相關(guān)的，從而推測(cè)此類(lèi)患者預(yù)后相對(duì)較好。（4）CD3、CD45RO在抗瘤過(guò)程中可能有相關(guān)性。（5）與傳統(tǒng)UICC—TNM組織學(xué)分級(jí)評(píng)估預(yù)后不同，通過(guò)對(duì)CD3、CD45RO的檢測(cè)研究可以從另外一個(gè)層面評(píng)估鼻咽癌的預(yù)后情況，并為其細(xì)胞免疫治療提供理論依據(jù)。
[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(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R739.63

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