【摘要】：目的:本實驗主要從鼻內翻性乳頭狀瘤(nasal inverted papilloma,NIP)的病理形態(tài)出發(fā),根據NIP的病理特點及細胞凋亡與腫瘤發(fā)生的關系,采用免疫組織化學方法檢測細胞凋亡相關因子X-連鎖凋亡抑制蛋白(X-linked inhibitor of apoptosis pretein,XIAP)及凋亡蛋白酶活化因子-1(apoptptic protease activating factor-1,Apaf-1)在NIP中的表達情況并分析其相互關系。探討細胞凋亡機制在NIP發(fā)生發(fā)展中的作用,為NIP的早期臨床診斷及疾病的發(fā)展程度提供新的參考依據,為NIP的治療也提供了新的指導依據。 方法:采用兔抗人XIAP多克隆抗體和兔抗人Apaf-1多克隆抗體,通過免疫組織化學技術檢測25例NIP組織標本中XIAP及Apaf-1的表達;同時以鼻鱗狀細胞癌(nasal squamous cell carcinoma, NSCC)及正常下鼻甲(inferior turbinate,IT)組織為對照組,檢測21例NSCC存檔蠟塊標本及18例IT標本中XIAP及Apaf-1的表達,實驗數據采用SPSS17.0軟件包X~2檢驗及Spearman相關分析等。 結果:(1)XIAP在IT、NIP、NSCC中的表達陽性率分別是16.67%(3/18)、60.00%(15/25)、90.48%(19/21),兩兩相比,差異均有顯著性(P0.05)。(2)Apaf-1在IT、NIP、NSCC中的表達陽性率分別是94.44%(17/18)、64.00%(16/25)、23.81%(5/21),兩兩相比,其差異均有顯著性(P0.05)。(3)在15例XIAP陽性表達的NIP中Apaf-1陽性表達例數為13例,在Apaf-1陽性表達的16例NIP病例中XIAP陽性及陰性例數分別是13例和3例,兩者相比差異具有顯著性(X~2=8.362,P0.05),據Spearman統(tǒng)計分析結果Rs=-0.895,可知NIP中XIAP與Apaf-1的表達呈負相關。 結論:XIAP及Apaf-1在NIP中表達介于IT與NSCC之間,表達率分別呈遞增及遞減趨勢,兩兩相比均具有顯著差異(P0.05),提示XIAP的升高與Apaf-1的降低與腫瘤的發(fā)生發(fā)展有密切關系。XIAP與Apaf-1在NIP的表達具有負相關性,且在不同的NIP病例中二者的表達程度不同,提示XIAP異常高表達與Apaf-1明顯低表達的病例可能更易惡性變或復發(fā)。通過對二者的檢測可以對NIP的早期發(fā)現,發(fā)展及惡性變等生物學行為提供依據,從而為有效治療NIP,選用合理的手術方式提供理論依據。
[Abstract]:Objective: this study was based on the pathological morphology of nasal inverted papilloma (nasal inverted papilloma,NIP), according to the pathological characteristics of NIP and the relationship between apoptosis and tumorigenesis. The expression of apoptosis-related factor X- linkage inhibitor of apoptosis protein (X-linked inhibitor of apoptosis pretein,XIAP) and apoptotic protease activator 1 (apoptptic protease activating factor-1,Apaf-1 in NIP was detected by immunohistochemical method and the relationship between them was analyzed. To explore the role of apoptosis mechanism in the pathogenesis and development of NIP, to provide a new reference for the early clinical diagnosis and disease development of NIP, as well as a new guiding basis for the treatment of NIP. Methods: using rabbit anti-human XIAP polyclonal antibody and rabbit anti-human Apaf-1 polyclonal antibody, the expression of XIAP and Apaf-1 in 25 cases of NIP were detected by immunohistochemistry. The expression of XIAP and Apaf-1 in 21 cases of NSCC archived wax and 18 cases of IT were detected with (nasal squamous cell carcinoma, NSCC) and normal inferior turbinate (inferior turbinate,IT) as control group. The data were detected by SPSS17.0 software X2 and Spearman correlation analysis. Results: (1) the positive rates of XIAP expression in IT,NIP,NSCC were 16.67% (3 / 18), 60.00% (15 / 25), 90.48% (19 / 21), respectively (P0.05). (2). The positive rates of Apaf-1 in IT,NIP,NSCC were 94.44% (17 / 18), 64.00% (16 / 25), 23.81% (5 / 21), respectively. There were significant differences between them (P0.05). (3). The number of Apaf-1 positive expression in NIP of 15 XIAP positive cases was 13, and the XIAP positive and negative in Apaf-1 positive NIP was 13 and 3, respectively. There was significant difference between the two groups (P 0.05). According to Spearman statistical analysis, the expression of XIAP and Apaf-1 in NIP was negatively correlated with that of XIAP. Conclusion: the expression of XIAP and Apaf-1 in NIP is between IT and NSCC, and the expression rate is increasing and decreasing, respectively. There was significant difference between the two groups (P0.05), which suggested that the increase of XIAP and the decrease of Apaf-1 were closely related to the occurrence and development of tumor. The expression of XIAP and Apaf-1 in NIP was negatively correlated, and the expression degree of XIAP and Apaf-1 in different NIP cases was different. The results suggest that the cases with abnormal high expression of XIAP and obvious low expression of Apaf-1 may be more prone to malignant change or recurrence. The detection of both can provide the basis for the early detection, development and malignant change of NIP, so as to provide theoretical basis for the effective treatment of NIP, with reasonable surgical methods.
【學位授予單位】：佳木斯大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R739.62

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