【摘要】：目的：通過(guò)對(duì)39例聲門上型喉癌及深部不同距離手術(shù)切緣CK-19表達(dá)的研究，為臨床確定不同分期聲門上型喉癌手術(shù)的深部安全切緣提供依據(jù)。 方法：收集臨床資料完整的聲門上型喉癌標(biāo)本39例，作縱向每3mm距離連續(xù)切片，取腫瘤最大面的組織塊連續(xù)切片，分別采用PV6001免疫組織化學(xué)兩步法及RT-PCR方法檢測(cè)39例聲門上型喉癌組織及不同距離深部切緣組織中CK-19的表達(dá)及CK-19mRNA轉(zhuǎn)錄情況。 結(jié)果：(1)TI-T2期聲門上型喉癌：CK-19表達(dá)癌組織與0.2cm、0.5cm、1cm深部切緣比較均有顯著性差異(p0.05)；0.2cm、0.5cm、1cm切緣三者之間無(wú)顯著性差異(p0.05)。(2)T3期聲門上型喉癌：CK-19表達(dá)癌組織與0.2cm切緣表達(dá)無(wú)顯著性差異(p0.05)；0.5cm和1cm無(wú)顯著性差異(p0.05)；癌組織與0.5cm，0.2cm與0.5cm有顯著性差異(p0.05)。(3)T4期聲門上型喉癌：CK-19表達(dá)癌組織與0.2cm、0.5cm表達(dá)均無(wú)顯著性差異(p0.05)；癌組織和1cm有顯著性差異(p0.05)；0.2cm與1cm、0.5cm與1cm之間均有顯著性差異(p0.05)。 結(jié)論：聲門上喉癌原發(fā)灶T分期越晚，腫瘤黏膜下侵襲程度越重。T1-T2期聲門上型喉癌，腫瘤深部2mm處CK-19表達(dá)與腫瘤組有明顯差異，手術(shù)切緣至少保證2mm以上；T3期聲門上型喉癌，腫瘤深部5mm處CK-19表達(dá)與腫瘤組差異明顯，手術(shù)切緣應(yīng)至少保證5mm；T4期聲門上型喉癌，腫瘤深部5mm處CK-19表達(dá)與腫瘤組無(wú)明顯差異，10mm處與腫瘤組有差異，手術(shù)切緣應(yīng)選擇5mm至10mm范圍。
[Abstract]:Objective: to study the expression of CK-19 in 39 patients with supraglottic laryngocarcinoma and deep resection margin in order to provide evidence for clinical determination of deep safe margin of supraglottic laryngeal carcinoma at different stages. Methods: 39 cases of supraglottic laryngeal carcinoma with complete clinical data were collected. The tissue mass of the largest surface of the tumor was sectioned continuously by longitudinal section per 3mm distance. The expression of CK-19 and CK-19mRNA transcription in 39 cases of supraglottic laryngeal carcinoma tissues and deep incised margin tissues were detected by PV6001 immunohistochemical two-step method and RT-PCR method respectively. Results: (1) there was no significant difference between the expression of CK-19 and the deep incisal margin of 0.2cm ~ (0.5) cm ~ (-1) in TI-T2 stage supraglottic carcinoma (p0.05). There was no significant difference among the three groups (p0.05). (_ 2). There was no significant difference between the expression of CK-19 and 0.2cm (p0.05). There was no significant difference between 0.5cm and 1cm (p0.05), and there was no significant difference between cancer tissue and 0.5 cm ~ 0.2cm and 0.5cm (p0.05). (_ 3). There was no significant difference in the expression of CK-19 and 0.2cm ~ (0.5 cm) between cancer tissues and 1cm (p0.05) in stage T4 supraglottic laryngocarcinoma (p0.05). There was a significant difference between 0.2cm and 1 cm, 0.5 cm and 1cm (p0.05). Conclusion: the later the T stage of supraglottic carcinoma is, the more severe the submucosal invasion is. T1-T2 stage supraglottic laryngeal carcinoma. The expression of CK-19 in the deep part of the tumor is significantly different from that in the tumor group, and the surgical margin at least ensures the supraglottic laryngeal carcinoma above 2mm stage T3. The expression of CK-19 in the deep 5mm of the tumor was significantly different from that in the tumor group. The operative margin should ensure at least 5mm T4 supraglottic laryngeal carcinoma. There was no significant difference in the expression of CK-19 between the deep 5mm of the tumor and the tumor group at 10mm and that in the tumor group. The range of 5mm to 10mm should be selected at the surgical margin.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R739.65

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