本文關(guān)鍵詞： 微小染色體維持蛋白2 生長素 宮頸癌 新輔助化療　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:微小染色體維持蛋白2(Minichromosome maintenance protein 2,MCM2)與Survivin可以促進(jìn)宮頸癌細(xì)胞的增殖,抑制其凋亡,因此兩者在宮頸癌的進(jìn)展過程中有一定的作用。通過檢測局部晚期宮頸癌患者新輔助化療(Neoadjuvant chemotherapy,NACT)前后MCM2與Survivin的表達(dá)水平變化,了解NACT對(duì)其表達(dá)的影響。探討局部晚期宮頸癌NACT前MCM2、Survivin的相關(guān)性及其與NACT療效的相關(guān)性,旨在做到預(yù)見性化療,為有效評(píng)估NACT療效提供敏感性的預(yù)測指標(biāo)。方法:選取2015年3月-2016年7月山西醫(yī)科大學(xué)第二醫(yī)院婦科門診經(jīng)陰道鏡活檢確診為局部晚期宮頸癌的患者30例。陰道鏡檢查后用活檢鉗鉗夾宮頸癌組織,用0.9%Nacl沖洗組織血漬,鋁箔紙將其包裹,并存入液氮罐。入選患者均無化療禁忌癥,且未接受過手術(shù)及放射治療,在患者簽署知情同意書的情況下給予2個(gè)療程的TC方案(紫杉醇+卡鉑)化療,后行宮頸癌根治術(shù)時(shí)再次留取相應(yīng)患者的新鮮宮頸癌組織,存放入液氮罐。提取宮頸癌組織的總RNA和總蛋白,采用Real-time q PCR和Western blot方法檢測NACT前后MCM2和Survivin的m RNA和蛋白表達(dá)水平的變化。結(jié)果:1.局部晚期宮頸癌患者行NACT后腫瘤直徑明顯縮小,由化療前的(42.43±5.90)mm縮小至(24.29±1.60)mm(P0.05),臨床總有效率為83.3%。2.局部晚期宮頸癌患者行NACT后MCM2與Survivin的表達(dá)較化療前均降低。RT-q PCR檢測化療后MCM2與Survivin的m RNA相對(duì)表達(dá)量為0.62±0.11、0.86±0.13,與化療前的m RNA表達(dá)量1.31±0.23、1.28±0.19相比顯著降低(P0.05)。Western blot檢測化療后MCM2與Survivin的蛋白相對(duì)表達(dá)量為0.18±0.02、0.19±0.02,與化療前的蛋白相對(duì)表達(dá)量0.90±0.02、0.49±0.03相比顯著降低(P0.05)。3.局部晚期宮頸癌患者NACT前有效組中MCM2與Survivin的表達(dá)均高于無效組。RT-q PCR檢測有效組中MCM2與Survivin的m RNA相對(duì)表達(dá)量為1.52±0.26、1.45±0.21,相比無效組中的m RNA表達(dá)量0.40±0.06、0.40±0.03明顯增高(P0.05)。Western blot檢測有效組中MCM2與Survivin的蛋白相對(duì)表達(dá)量為0.94±0.01、0.52±0.02,相比與無效組中的蛋白表達(dá)量0.75±0.02、0.34±0.01明顯增高(P0.05)。4.NACT前MCM2與Survivin在局部晚期宮頸癌中的表達(dá)經(jīng)Pearson積差相關(guān)系數(shù)分析發(fā)現(xiàn)具有正相關(guān)性,相關(guān)系數(shù)r為0.876。結(jié)論:1.局部晚期宮頸癌中MCM2和Survivin在患者行NACT后表達(dá)水平明顯低于化療前,提示其可能作為評(píng)估和預(yù)測NACT對(duì)宮頸癌患者作用的有效篩選指標(biāo)。2.在局部晚期宮頸癌療效有效組中MCM2、Survivin有高表達(dá),提示其表達(dá)程度有助于評(píng)判患者對(duì)行NACT的敏感性。
[Abstract]:Objective: minichromosome maintenance protein 2 (Minichromosome maintenance 2 protein, MCM2) and Survivin can promote the proliferation of cervical cancer cells, inhibition of apoptosis, so they have a certain role in the progression of cervical cancer. Neoadjuvant chemotherapy for locally advanced cervical cancer patients were detected by (Neoadjuvant chemotherapy, NACT) and the changes of MCM2 expression level before and after Survivin, to understand the impact of NACT on the expression of locally advanced cervical cancer before NACT MCM2, the correlation of Survivin and its correlation with the efficacy of NACT, aiming at the predictability of chemotherapy, provide a predictor of sensitivity to effectively assess the efficacy of NACT. Methods: from March 2015 July -2016 Shanxi Medical University second hospital gynecology clinic by colposcopy biopsy for 30 cases of locally advanced cervical cancer. Patients with cervical cancer tissue forceps colposcopy, washed by 0.9%Nacl Tissue blood, foil wrapped it, and stored in liquid nitrogen tank. All patients had no chemotherapy contraindications, and did not receive surgery and radiotherapy, TC regimen in patients signed informed consent under the condition of given 2 courses (paclitaxel + carboplatin) chemotherapy after radical resection of cervical cancer specimens from the corresponding again patients with fresh cervical cancer, stored in liquid nitrogen tank. Total RNA was extracted from cervical carcinoma tissue and total protein, using Real-time Q PCR and Western blot method to detect the NACT before and after M RNA and MCM2 protein and Survivin expression. Results: 1. patients with late local cervical carcinoma in stage NACT tumor diameter significantly decreased after. After chemotherapy (42.43 + 5.90) mm was reduced to (24.29 + 1.60) mm (P0.05), the total effective rate was 83.3%.2. in patients with locally advanced cervical cancer after NACT the expression of MCM2 and Survivin were lower than before chemotherapy,.RT-q PCR and Survi MCM2 test measured after chemotherapy M RNA the relative expression of VIN was 0.62 + 0.11,0.86 + 0.13, M Expression and RNA before chemotherapy was 1.31 + 0.23,1.28 + 0.19 was significantly lower than (P0.05).Western blot detection of MCM2 after chemotherapy and Survivin protein expression was 0.18 + 0.02,0.19 + 0.02, and the protein expression before chemotherapy was 0.90 + 0.02,0.49 + 0.03 (P0.05) was significantly lower than the expression of MCM2 Survivin and.3. NACT in patients with locally advanced cervical cancer before the effective group were higher than in M RNA group Survivin.RT-q PCR invalid MCM2 and effective detection of relative expression level was 1.52 + 0.26,1.45 + 0.21, RNA group compared to invalid m expression in 0.40 + 0.06,0.40 + 0.03 significantly increased (P0.05) and MCM2 Survivin.Western blot detection group in protein relative expression was 0.94 + 0.01,0.52 + 0.02, compared with the expression of the protein in the amount of invalid group 0.75 + 0.02,0.34 + 0.01 was significantly higher (P0.05).4.NACT MCM2 and Su The expression of rvivin in locally advanced cervical cancer by Pearson correlation coefficient analysis showed a positive correlation, the correlation coefficient r was 0.876. conclusion: MCM2 and Survivin 1. in locally advanced cervical cancer in patients after NACT expression levels were significantly lower than before chemotherapy, suggesting that it may be as the assessment and prediction of MCM2.2. effective screening index of patients with cervical cancer NACT in locally advanced cervical cancer group, Survivin high expression, suggesting that its expression level is helpful to judge the patient sensitivity to NACT.

【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】：2017
【分類號(hào)】：R737.33

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本文編號(hào)：1533020