本文選題：人內(nèi)源性逆轉(zhuǎn)錄病毒-H長末端重復(fù)關(guān)聯(lián)蛋白2　切入點：程序性死亡配體1　出處：《西南醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:腫瘤微環(huán)境中的重要免疫分子人內(nèi)源性逆轉(zhuǎn)錄病毒-H長末端重復(fù)關(guān)聯(lián)蛋白2(human endogenous retrovirus subfamily H long terminal repeat associating protein 2,HHLA2)和程序性死亡配體1(programmed celldeath-ligand 1,PD-L1),在腫瘤的發(fā)生、發(fā)展過程中發(fā)揮重要的調(diào)控作用。本研究通過檢測非小細胞肺癌(non-small cell lung cancer,NSCLC)組織中HHLA2和PD-L1的表達情況,并分析其與非小細胞肺癌患者臨床病理特征間的關(guān)系,探討HHLA2和PD-L1在非小細胞肺癌的發(fā)生、發(fā)展、浸潤及轉(zhuǎn)移過程中的作用。方法:選取西南醫(yī)科大學(xué)附屬第一醫(yī)院病理科2015年1月至2015年12月手術(shù)切除的60例(肺腺癌30例,肺鱗癌30例)NSCLC石蠟包埋存檔組織塊,據(jù)手術(shù)切除標(biāo)本大小,嚴格按照距NSCLC腫瘤組織灶3cm的標(biāo)準取癌旁肺組織,共30例(鱗癌18例、腺癌12例)作為癌旁肺組織對照組,所有入選病例均排除其他肺部疾病及其他組織、器官的惡性腫瘤,術(shù)前未行化療、放療、免疫治療及其他針對惡性腫瘤的治療;并選取30例經(jīng)病理確診的正常肺組織為對照組。采用免疫組織化學(xué)En Vision法檢測NSCLC組織中HHLA2與PD-L1的表達情況,并比較非小細胞肺癌的HHLA2和PD-L1表達在年齡、病理分型、分期、吸煙情況和性別間的差異。結(jié)果:1.NSCLC組織中HHLA2的陽性表達率為81.67%,明顯高于其在癌旁肺組織上皮細胞中的陽性表達率13.33%和正常肺組織上皮細胞中的陽性表達率0.00%,且差異有統(tǒng)計學(xué)意義(P0.05);而HHLA2在正常肺組織上皮細胞及癌旁肺組織上皮細胞中的表達差異無統(tǒng)計學(xué)意義(P0.05),HHLA2表達與NSCLC的臨床分期、淋巴結(jié)轉(zhuǎn)移、性別、年齡、吸煙情況及病理分型無相關(guān)性。2.NSCLC組織中PD-L1的陽性表達率為53.33%,明顯高于其在癌旁肺組織上皮細胞中的陽性表達率(0.00%)和正常肺組織上皮細胞中的陽性表達率(0.00%),且差異有統(tǒng)計學(xué)意義(P0.05);PD-L1表達與NSCLC的臨床分期(P0.05)、淋巴結(jié)轉(zhuǎn)移(P0.05)相關(guān),但與其性別、年齡、吸煙情況、病理分型無相關(guān)性。3.NSCLC組織中HHLA2和PD-L1的表達具有相關(guān)性(r=0.503,P0.01)。結(jié)論:1.非小細胞肺癌組織中HHLA2的表達顯著增高,可能成為免疫檢查及治療的新靶點。2.非小細胞肺癌組織中PD-L1的表達顯著增高,與TNM分期有關(guān),提示在NSCLC的發(fā)生、發(fā)展、浸潤及轉(zhuǎn)移過程中發(fā)揮了重要作用。3.HHLA2及PD-L1在非小細胞肺癌組織中的表達呈正相關(guān),提示它們可能在NSCLC的發(fā)生、發(fā)展過程中發(fā)揮協(xié)同作用。
[Abstract]:Objective: an important immune molecule of human endogenous retrovirus long terminal repeat associated protein -H in tumor microenvironment (2 human endogenous retrovirus subfamily H long terminal repeat associating protein 2, HHLA2) and programmed death ligand 1 (programmed celldeath-ligand 1, PD-L1), in the incidence of cancer, play an important role in the process of development. This study through the detection of non-small cell lung cancer (non-small cell lung cancer, NSCLC) expression of HHLA2 and PD-L1 in tissues, and analyze its relationship with clinical pathological features of patients with non-small cell lung cancer. The study of HHLA2 and PD-L1 in non-small cell lung cancer occurrence, development, invasion and metastasis process. The first Affiliated Hospital from Southwestern Medical School pathology from January 2015 to December 2015 for 60 cases surgery (30 cases, 30 cases of lung adenocarcinoma and lung squamous cell carcinoma) NSCLC paraffin embedding Tissue, according to surgical specimen size, the adjacent lung tissue from the tumor foci in strict accordance with the NSCLC 3cm standard, a total of 30 cases (18 cases of squamous cell carcinoma, 12 cases of adenocarcinoma of lung tissue adjacent to cancer) as the control group, all patients were excluded other diseases of the lungs and other organs of the organization, not malignant tumor. Preoperative radiotherapy, chemotherapy, immunotherapy and the other for the treatment of malignant tumor; and selected 30 cases of normal lung tissue by pathology were as control group. The expression of HHLA2 and PD-L1 in NSCLC tissues was detected by immunohistochemical En Vision method, and compare the expression of HHLA2 in non small cell lung cancer and PD-L1 in age. Pathological type, stage, smoking status and gender differences. Results: the positive expression of HHLA2 in 1.NSCLC tissues was 81.67%, significantly higher than the positive expression in adjacent lung epithelial cells in rate of 13.33% and the normal lung tissues in epithelial cells The positive expression rate of 0%, and the difference was statistically significant (P0.05); while there was no significant difference in the expression of HHLA2 in epithelial cancer cells and normal lung tissue adjacent lung tissue in epithelial cells (P0.05), the expression of HHLA2 NSCLC and clinical staging, lymph node metastasis, gender, age, smoking status and expression of PD-L1 pathology there was no significant correlation between.2.NSCLC tissues was 53.33%, significantly higher than the positive expression in adjacent lung epithelial cells in the positive expression rate (0%) and normal lung epithelial cells in the rate (0%), and the difference was statistically significant (P0.05); the expression of PD-L1 with clinical stage NSCLC (P0.05). Lymph node metastasis (P0.05), but their gender, age, smoking status, with a correlation between the expression of HHLA2 and PD-L1 had no correlation with pathological type in.3.NSCLC tissues (r=0.503, P0.01). Conclusion: 1. the expression of HHLA2 in non small cell lung cancer was significantly increased High, it may become a new target for immune examination and treatment of the.2. expression of PD-L1 in non-small cell lung cancer significantly associated with TNM stage, suggesting that the occurrence of NSCLC in the development, invasion and metastasis, plays an important role in.3.HHLA2 and PD-L1 expression in non-small cell lung cancer tissues, suggesting that they in NSCLC, play a synergistic role in the process of development.

【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R734.2

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