淚腺腺樣囊性癌嗜神經侵襲生長機制的免疫組化研究
發(fā)布時間：2018-09-12 06:18
【摘要】：研究目的 運用免疫組織化學的技術分析淚腺腺樣囊性癌(ACC)中三種雪旺氏細胞標記物S100、GFAP、Leu-7的表達并觀察其與淚腺ACC組織嗜神經侵襲(PNI)等生物學行為之間的關系及與組織學類型的關系進一步為明確淚腺腺樣囊性癌PNI機制提供實驗依據,了解它們在淚腺ACC PNI微環(huán)境中的作用與關系,為臨床尋找控制早期PNI的有效靶點提供參考依據。 研究方法 收集30例淚腺腺樣囊性癌患者組織標本蠟塊作為試驗組,用已知陽性片(神經鞘膜瘤)作陽性對照、用0.01mmol/LPBS代替一抗作陰性對照；同時搜集該30例淚腺腺樣囊性癌患者的個人信息； 將30例淚腺腺樣囊性癌患者的組織標本蠟塊和5例正常淚腺組織蠟塊進行切片及免疫組織化學染色；鏡下檢測試驗組中S100蛋白、GFAP、Leu-7表達情況并與正常淚腺組織進行比較；按嗜神經性的有無分組,分別鏡下分析各自的神經受侵率；按組織學類型分組(實體型、篩孔型、管狀型,因后兩者多混合存在,且本研究中樣本量較小,故歸為篩-管型,屬高分化,而實體型屬低分化)、按原發(fā)與復發(fā)分組,分別鏡下分析淚腺腺樣囊性癌組S100蛋白、GFAP、Leu-7表達的陽性率及神經受侵率； 采用SPSS19.0統計學分析軟件進行分析。對三種雪旺氏細胞標記物的表達結果進行分析,因n40,采用fisher確切概率法檢驗,以α=0.05為檢驗水準,當P0.05時,表明差異具有顯著性。 研究結果 1、30例淚腺腺樣囊性癌患者組織標本蠟塊切片經HE染色后,病理診斷結果與原取材的大組織診斷完全一致。 2、淚腺ACC組織中S100蛋白、GFAP均有不同程度表達,表達率依次為86.7%、83.3%,顯著高于淚腺正常組織；兩者染色均呈棕黃色為陽性,S100主要定位于胞漿和胞核中,GFAP主要在胞漿中表達；Leu-7在淚腺ACC與正常淚腺組織中均為陰性表達；低分化(實體型)ACC、復發(fā)組ACC的嗜神經侵襲率分別顯著高于高分化型(篩-管型)、原發(fā)組ACC的嗜神經侵襲率,差異具有顯著性(P0.05)。 3、低分化(實體型)ACC組織中的S100蛋白、GFAP表達率分別顯著高于其在高分化型(篩-管型)ACC組織中的表達率；復發(fā)組ACC組織中表達率S100蛋白、GFAP分別顯著高于其在原發(fā)組ACC組織中的表達率；有嗜神經侵襲組ACC中S100蛋白、GFAP的表達率分別顯著高于其在無嗜神經侵襲組ACC中的表達率,上述差異具有顯著性(P0.05)。 結論 1、淚腺ACC具有嗜神經侵襲性生物學行為,嗜神經侵襲現象可作為淚腺ACC預后不良的臨床觀察指標之一。 2、淚腺ACC的分化程度越低(惡性程度越高),神經受侵率越高；復發(fā)性淚腺ACC與原發(fā)性淚腺ACC相比較,復發(fā)性淚腺ACC更容易侵襲神經,臨床上可能引起不同程度的諸如疼痛及麻木等神經癥狀。 3、S100蛋白、GFAP分別在嗜神經組、復發(fā)組、低分化組中表達陽性率較高,可推測S100蛋白、GFAP在淚腺ACC嗜神經侵襲中發(fā)揮著一定作用,兩者可以作為判斷有無嗜神經侵襲現象的生物學指標。 4、Leu-7在淚腺ACC與正常淚腺組織中均為陰性表達,提示其與淚腺ACC的病變性質及神經侵襲無明確相關性。 5、淚腺ACC嗜神經機制是否與雪旺氏細胞分化有關,仍需要大樣本量及多種的標記物實驗證實,不同雪旺氏細胞標記物的敏感性及特異性均存在不同程度差異,尋求關于淚腺ACC PNI的特異性指標將成為一重要目標。
[Abstract]:research objective
The expression of three Schwann cell markers S100, GFAP and Leu-7 in lacrimal adenoid cystic carcinoma (ACC) was analyzed by immunohistochemical technique. The relationship between the expression of S100, GFAP and Leu-7 and the biological behavior of lacrimal ACC, such as neurotropic invasion (PNI), and the histological type of ACC was also observed. To understand their role and relationship in ACC PNI microenvironment of lacrimal gland, and to provide reference for clinical search for effective targets for early PNI control.
research method
Thirty cases of adenoid cystic carcinoma of lacrimal gland were collected as the experimental group, the known positive film (neurilemmoma) was used as the positive control, and 0.01 mmol/LPBS was used as the negative control.
30 cases of lacrimal adenoid cystic carcinoma and 5 cases of normal lacrimal gland tissue were sliced and immunohistochemically stained. The expression of S100 protein, GFAP, Leu-7 in the experimental group was detected under microscope and compared with that in the normal lacrimal gland tissue. Histologically grouped (solid type, ethmoidal type, tubular type, because the latter two are mixed, and the sample size in this study is small, it is classified as ethmoidal-tubular type, highly differentiated, but the solid type is poorly differentiated), according to the primary and recurrent grouping, the positive rates of S100 protein, GFAP, Leu-7 expression and nerve invasion in adenoid cystic carcinoma of lacrimal gland were analyzed under microscope. Rate;
SPSS19.0 statistical analysis software was used to analyze the expression results of three kinds of Schwann cell markers. Because of n40, Fisher exact probability method was used to test the expression of three kinds of Schwann cell markers. The test level was alpha=0.05. When P 0.05, the difference was significant.
Research results
After HE staining, the pathological diagnosis of 1,30 cases of adenoid cystic carcinoma of lacrimal gland was identical with that of the original large tissue.
2. The expression rates of S100 protein and GFAP in ACC tissues were 86.7% and 83.3% respectively, which were significantly higher than those in normal lacrimal gland tissues. The neurotropic invasion rate of metastatic (solid) ACC and recurrent ACC was significantly higher than that of well-differentiated (ethmoidal-tubular) ACC, and that of primary ACC was significantly higher (P 0.05).
3. The expression rates of S100 protein and GFAP in poorly differentiated (solid) ACC tissues were significantly higher than those in well differentiated (sieve-tube) ACC tissues; the expression rates of S100 protein and GFAP in recurrent ACC tissues were significantly higher than those in primary ACC tissues; the expression rates of S100 protein and GFAP in neurotropic invasive ACC tissues were significantly higher than those in primary ACC tissues. No significant difference was found in the expression rate of ACC in the non invasive group, and the difference was significant (P0.05).
conclusion
1. ACC of lacrimal gland has neurotropic invasive biological behavior, and neurotropic invasion can be used as one of the clinical indicators of poor prognosis of ACC of lacrimal gland.
2. The lower the degree of differentiation (the higher the degree of malignancy) of ACC in lacrimal gland, the higher the rate of nerve invasion; the recurrent lacrimal gland ACC is more likely to invade nerves than the primary lacrimal gland ACC, and may cause different degrees of clinical symptoms such as pain and numbness.
3. S100 protein and GFAP were expressed in the neurotropic group, recurrent group and poorly differentiated group respectively. It can be inferred that S100 protein and GFAP play a certain role in ACC neurotropic invasion of lacrimal gland. Both of them can be used as biological indicators to judge whether there is neurotropic invasion.
4. Leu-7 was negative in both lacrimal ACC and normal lacrimal gland tissues, suggesting that there was no definite correlation between Leu-7 and the pathological nature and nerve invasion of lacrimal ACC.
5. Whether the neural mechanism of ACC in lacrimal gland is related to the differentiation of Schwann cells still needs a large sample size and a variety of marker experiments to confirm that the sensitivity and specificity of different Schwann cell markers are different in varying degrees. It will be an important goal to seek specific indicators of ACC PNI in lacrimal gland.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R739.7
本文編號：2238157
[Abstract]:research objective
The expression of three Schwann cell markers S100, GFAP and Leu-7 in lacrimal adenoid cystic carcinoma (ACC) was analyzed by immunohistochemical technique. The relationship between the expression of S100, GFAP and Leu-7 and the biological behavior of lacrimal ACC, such as neurotropic invasion (PNI), and the histological type of ACC was also observed. To understand their role and relationship in ACC PNI microenvironment of lacrimal gland, and to provide reference for clinical search for effective targets for early PNI control.
research method
Thirty cases of adenoid cystic carcinoma of lacrimal gland were collected as the experimental group, the known positive film (neurilemmoma) was used as the positive control, and 0.01 mmol/LPBS was used as the negative control.
30 cases of lacrimal adenoid cystic carcinoma and 5 cases of normal lacrimal gland tissue were sliced and immunohistochemically stained. The expression of S100 protein, GFAP, Leu-7 in the experimental group was detected under microscope and compared with that in the normal lacrimal gland tissue. Histologically grouped (solid type, ethmoidal type, tubular type, because the latter two are mixed, and the sample size in this study is small, it is classified as ethmoidal-tubular type, highly differentiated, but the solid type is poorly differentiated), according to the primary and recurrent grouping, the positive rates of S100 protein, GFAP, Leu-7 expression and nerve invasion in adenoid cystic carcinoma of lacrimal gland were analyzed under microscope. Rate;
SPSS19.0 statistical analysis software was used to analyze the expression results of three kinds of Schwann cell markers. Because of n40, Fisher exact probability method was used to test the expression of three kinds of Schwann cell markers. The test level was alpha=0.05. When P 0.05, the difference was significant.
Research results
After HE staining, the pathological diagnosis of 1,30 cases of adenoid cystic carcinoma of lacrimal gland was identical with that of the original large tissue.
2. The expression rates of S100 protein and GFAP in ACC tissues were 86.7% and 83.3% respectively, which were significantly higher than those in normal lacrimal gland tissues. The neurotropic invasion rate of metastatic (solid) ACC and recurrent ACC was significantly higher than that of well-differentiated (ethmoidal-tubular) ACC, and that of primary ACC was significantly higher (P 0.05).
3. The expression rates of S100 protein and GFAP in poorly differentiated (solid) ACC tissues were significantly higher than those in well differentiated (sieve-tube) ACC tissues; the expression rates of S100 protein and GFAP in recurrent ACC tissues were significantly higher than those in primary ACC tissues; the expression rates of S100 protein and GFAP in neurotropic invasive ACC tissues were significantly higher than those in primary ACC tissues. No significant difference was found in the expression rate of ACC in the non invasive group, and the difference was significant (P0.05).
conclusion
1. ACC of lacrimal gland has neurotropic invasive biological behavior, and neurotropic invasion can be used as one of the clinical indicators of poor prognosis of ACC of lacrimal gland.
2. The lower the degree of differentiation (the higher the degree of malignancy) of ACC in lacrimal gland, the higher the rate of nerve invasion; the recurrent lacrimal gland ACC is more likely to invade nerves than the primary lacrimal gland ACC, and may cause different degrees of clinical symptoms such as pain and numbness.
3. S100 protein and GFAP were expressed in the neurotropic group, recurrent group and poorly differentiated group respectively. It can be inferred that S100 protein and GFAP play a certain role in ACC neurotropic invasion of lacrimal gland. Both of them can be used as biological indicators to judge whether there is neurotropic invasion.
4. Leu-7 was negative in both lacrimal ACC and normal lacrimal gland tissues, suggesting that there was no definite correlation between Leu-7 and the pathological nature and nerve invasion of lacrimal ACC.
5. Whether the neural mechanism of ACC in lacrimal gland is related to the differentiation of Schwann cells still needs a large sample size and a variety of marker experiments to confirm that the sensitivity and specificity of different Schwann cell markers are different in varying degrees. It will be an important goal to seek specific indicators of ACC PNI in lacrimal gland.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R739.7
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