發(fā)布時間：2019-07-06 16:23

【摘要】：研究背景與目的鼻內(nèi)翻乳頭狀瘤(sinonasal inverted papilloma, NIP)是一種發(fā)生于鼻腔及鼻竇粘膜上皮的良性增生性病變,其典型的組織病理學(xué)特征為復(fù)層上皮向內(nèi)翻轉(zhuǎn)長入間質(zhì)組織中。臨床上,NIP主要面臨三個問題:局部侵襲,復(fù)發(fā)傾向及惡變傾向。因而,治療上除徹底手術(shù)切除外,還應(yīng)進(jìn)行長期術(shù)后隨訪。鱗癌抗原(squamous cell carcinoma antigen, SCCA)是一種腫瘤相關(guān)蛋白,它最早被發(fā)現(xiàn)于宮頸癌組織中。目前, SCCA作為一種鱗癌相關(guān)實驗室指標(biāo)被廣泛應(yīng)用。近來,有研究發(fā)現(xiàn)NIP患者的血清SCCA水平明顯增高,并且其術(shù)后血清SCCA水平較術(shù)前明顯下降。因此,SCCA有可能作為一種針對NIP有用的生物學(xué)指標(biāo)加以應(yīng)用。本次實驗的目的在于研究SCCA在NIP組織中的表達(dá)情況,評估SCCA作為NIP相關(guān)的生物學(xué)指標(biāo)加以臨床應(yīng)用的可能性。 材料與方法采用免疫組化對31例NIP標(biāo)本、15例鼻息肉(nasal polyp, NP)標(biāo)本及8例鼻腔鱗癌(nasal squamous cell carcinoma, NSCC)標(biāo)本進(jìn)行SCCA單克隆抗體標(biāo)記染色。所有標(biāo)本均來自安徽省立醫(yī)院耳鼻喉科術(shù)后病理標(biāo)本,標(biāo)本經(jīng)10%福爾馬林溶液固定,常規(guī)石蠟包埋,采用4μm切片厚度連續(xù)切片。 結(jié)果所有標(biāo)本均可見SCCA免疫反應(yīng)陽性。對比NIP標(biāo)本與NP標(biāo)本、NSCC標(biāo)本的染色,可見NIP標(biāo)本的染色明顯強(qiáng)于NP標(biāo)本及NSCC標(biāo)本。其染色強(qiáng)度等級差異有統(tǒng)計學(xué)意義(NIP與NP標(biāo)本對比χ~2= 16.847,P0.01;NIP與NSCC標(biāo)本對比χ~2= 4.648;P0.05)。在NIP標(biāo)本中,大多數(shù)標(biāo)本的染色部位在基底層之上的上皮細(xì)胞,其基底層細(xì)胞染色為陰性,但在3例術(shù)后隨訪發(fā)現(xiàn)惡變的病例,其標(biāo)本基底層染色均為陽性。惡變NIP標(biāo)本與無惡變NIP標(biāo)本的基底層染色率對比,其差異有統(tǒng)計學(xué)意義(χ~2 =11.394; P0.05)。 結(jié)論本研究顯示,SCCA在NIP標(biāo)本中有強(qiáng)陽性表達(dá),這表明SCCA在NIP的發(fā)生發(fā)展中可能起到一定的作用。臨床上,對SCCA的檢測可用作NIP診斷治療及術(shù)后隨訪的一項有用的生物學(xué)指標(biāo)。NIP惡變病例基底層細(xì)胞SCCA染色均為陽性,臨床上可考慮將SCCA基底層染色作為判斷NIP惡變傾向的指標(biāo)。
文內(nèi)圖片：
圖片說明：NIP常規(guī)HE染色×100Fig1：NIP，H&Estain×100
[Abstract]:Background and objective (sinonasal inverted papilloma, NIP) is a benign hyperplastic lesion occurring in the mucosa of nasal cavity and paranasal sinus. its typical histopathological feature is that the lamellar epithelial layer is turned inward into the stroma. Clinically, NIP mainly faces three problems: local invasion, recurrence tendency and malignant transformation tendency. Therefore, in addition to thorough surgical resection, long-term postoperative follow-up should be carried out. Squamous cell carcinoma antigen (squamous cell carcinoma antigen, SCCA) is a tumor-associated protein, which was first found in cervical cancer. At present, SCCA is widely used as a laboratory index related to squamous cell carcinoma. Recently, it has been found that the level of serum SCCA in patients with NIP is significantly higher than that before operation, and the level of serum SCCA after operation is significantly lower than that before operation. Therefore, SCCA may be used as a useful biological index for NIP. The purpose of this study was to study the expression of SCCA in NIP and to evaluate the possibility of clinical application of SCCA as a biological index related to NIP. Materials and methods Immunohistochemical staining of 31 cases of NIP, 15 cases of nasal polyp (nasal polyp, NP) and 8 cases of nasal squamous cell carcinoma (nasal squamous cell carcinoma, NSCC) were stained with SCCA monoclonal antibody. All the specimens were collected from the department of otolaryngology, Anhui Provincial Hospital. The specimens were fixed with 10% formalin solution and embedded in paraffin. The specimens were sectioned continuously with 4 渭 m slice thickness. Results all the specimens were positive for SCCA. Comparing the staining of NIP specimens with NP specimens and NSCC specimens, it can be seen that the staining of NIP specimens is significantly stronger than that of NP specimens and NSCC specimens. There was significant difference in staining intensity between NIP and NP (蠂 ~ 2 = 16.847, P < 0.01 / nip and NSCC, P ~ 2 = 4.648, P < 0.05). In NIP specimens, most of the specimens were stained in the epithelial cells above the basal layer, and the basal cells were negative, but in 3 cases of malignant transformation, the staining of the basal layer of the specimens was positive. There was significant difference in the staining rate of basal layer between malignant NIP specimens and non-malignant NIP specimens (蠂 ~ 2 = 11.394; P 0.05). Conclusion SCCA is strongly positive in NIP samples, which indicates that SCCA may play a role in the occurrence and development of NIP. Clinically, the detection of SCCA can be used as a useful biological index for the diagnosis, treatment and postoperative follow-up of NIP. SCCA staining of basal cells in nip malignant transformation cases is positive, and SCCA basal staining can be considered as an index to judge the malignant transformation tendency of NIP.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R739.62

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