本文選題：結(jié)直腸癌　切入點(diǎn)：丙酮酸激酶M1　出處：《四川醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過免疫組化方式對(duì)結(jié)直腸癌(Colorectal Carcinoma,CRC)組織病理切片進(jìn)行分析,研究丙酮酸激酶M1(Pyruvate kinase M1,M1-PK)和丙酮酸激酶M2(Pyruvate kinase M2,M2-PK)在不同臨床及病理分期的CRC組織及癌旁正常結(jié)直腸組織中的表達(dá)與CRC臨床病理特征的關(guān)系,探討M1-PK和M2-PK在CRC中的表達(dá)與其疾病發(fā)展的關(guān)系。方法:本實(shí)驗(yàn)標(biāo)本全部來自宜賓市第一人民醫(yī)院病理科的手術(shù)切除組織,時(shí)間段集中在2013年1月-2015年1月,共選擇CRC組織標(biāo)本69份,同時(shí)選擇癌旁正常結(jié)直腸組織標(biāo)本69份作為對(duì)照樣本,所有病理標(biāo)本必須具備完整甲級(jí)臨床病歷。病歷記錄詳細(xì)、規(guī)范,手術(shù)資料及影像學(xué)資料完備�；颊吣挲g45-82歲之間,中位年齡65歲,包含32例男性及37例女性,治療過程要求詳細(xì)。CRC組織學(xué)類型包含41例管狀腺癌、20例乳頭狀腺癌,還有其它病理類型癌8例;CRC分化程度包含48例中分化癌、21例低分化癌。采用免疫組織化學(xué)鏈霉菌抗生物素蛋白-過氧化物酶連結(jié)法(streptavidin-peroxidase,SP)檢測M1-PK和M2-PK在CRC組織中的表達(dá),在低分化組、中分化組與正常癌旁組織間對(duì)比。采用單因素和多因素分析比較M1-PK和M2-PK在CRC的低分化組、中分化組與正常癌旁組織中表達(dá)與臨床病理特征之間的關(guān)系。采用相關(guān)分析比較CRC中M1-PK與M2-PK表達(dá)的相關(guān)性。結(jié)果:1.M1-PK與M2-PK在CRC組織及癌旁正常組織中的表達(dá)與分布:M1-PK與M2-PK在正常結(jié)腸上皮細(xì)胞及CRC上皮細(xì)胞中均可見表達(dá),呈細(xì)胞質(zhì)分布,棕黃色顆粒為陽性信號(hào)表現(xiàn)。M1-PK在結(jié)直腸癌組織中表達(dá)微弱,低于癌旁正常組織(平均光密度值(Average optical density,AOD):對(duì)照組0.320±0.026;癌組織組0.231±0.023 P0.05);M2-PK在結(jié)直腸癌組織中表達(dá)明顯高于癌旁正常組織(AOD:對(duì)照組0.207±0.056;癌組織組0.347±0.054 P0.05);M1-PK在CRC組織中表達(dá)隨著腫瘤分化程度降低而減少(AOD:對(duì)照組0.320±0.026;中等分化組0.260±0.016;低分化組0.167±0.059;P0.05);M2-PK在CRC組織中表達(dá)隨著腫瘤分化程度降低而增加(AOD:對(duì)照組0.207±0.056;中等分化組0.259±0.068;低分化組0.420±0.019;P0.05);2.采用單因素和多因素分析比較M1-PK和M2-PK在CRC的低分化組、中分化組與正常癌旁組織中表達(dá)與臨床病理特征之間的關(guān)系顯示:M1-PK在CRC組織中的陽性表達(dá)與分化程度密切相關(guān)(P0.05),而與患者年齡、腫瘤大小、腫瘤部位、TNM臨床分期及淋巴結(jié)轉(zhuǎn)移無關(guān)。M2-PK在CRC組織中的陽性表達(dá)與腫瘤大小、腫瘤臨床TNM分期及腫瘤分化程度密切相關(guān)(P0.05),而與患者年齡、腫瘤部位、是否存在淋巴結(jié)轉(zhuǎn)移無明顯關(guān)系。3.CRC組織中M1-PK的表達(dá)水平與M2-PK表達(dá)的相關(guān)性:采用直線相關(guān)分析結(jié)果顯示:M1-PK與M2-PK表達(dá)AOD比較,r=-0.689,P0.01,提示呈負(fù)相關(guān)關(guān)系。結(jié)論:1.M1-PK與M2-PK在CRC上皮細(xì)胞以及正常結(jié)腸上皮細(xì)胞中均有所表達(dá),而并非只特異表達(dá)其中之一。2.M2-PK在CRC細(xì)胞中表達(dá)量能初步反應(yīng)腫瘤大小、腫瘤分期及腫瘤分化程度。3.從組織表達(dá)的角度提示,M2-PK與人CRC的惡性程度及進(jìn)展呈正相關(guān),而M1-PK與人CRC的惡性程度及進(jìn)展呈負(fù)相關(guān)。
[Abstract]:Objective: by immunohistochemical methods on colorectal cancer (Colorectal Carcinoma, CRC) histopathological analysis of pyruvate kinase M1 (Pyruvate kinase M1 M1-PK M2 (Pyruvate) and pyruvate kinase kinase M2, M2-PK) in different clinical and pathologic staging of CRC tissues and adjacent normal colorectal tissues and the expression of the clinical pathological features of CRC, to explore the relationship between M1-PK and M2-PK expression in CRC and the development of the disease. Methods: in this experiment, all specimens from the pathology department of Yibin First People's Hospital of the resected tissue, concentrated period of time in January 2013 -2015 year in January, total 69 CRC samples, and adjacent normal colorectal tissue specimens from 69 as the control samples, all specimens must have complete clinical records. A detailed specification, operation data and imaging data of 45-82 patients with complete age. Years old, the median age was 65 years, including 32 cases of male and 37 cases female, histological type contains 41 cases of tubular adenocarcinoma treatment process requires detailed.CRC tissue, 20 cases of papillary adenocarcinoma, and other pathological types of carcinoma in 8 cases; the differentiation of CRC containing 48 cases of undifferentiated carcinoma in 21 cases, poorly differentiated carcinoma. Using immunohistochemical streptavidin peroxidase conjugated method (streptavidin-peroxidase, SP) to detect the expression of M1-PK and M2-PK in CRC tissues, in low differentiation group, middle differentiation group and normal adjacent tissues. Compared with single factor and multi factor analysis and comparison of M1-PK and M2-PK in low differentiation group CRC the expression, relationship with clinicopathological features in differentiation group and normal paracancerous tissues. The correlation using correlation analysis expression of M1-PK compared with M2-PK CRC. Results: the expression of 1.M1-PK and M2-PK in CRC and normal tissues and the distribution of M1-PK and M2-PK In normal colonic epithelial cells and epithelial cells were found in the expression of CRC, a cytoplasmic distribution, brown yellow particles for positive signal expression of.M1-PK in colorectal cancer tissues was weak, lower than that in adjacent normal tissues (average optical density value (Average optical density, AOD): the control group 0.320 + 0.026; 0.231 + cancer group 0.023 P0.05); the expression of M2-PK in colorectal cancer tissues was significantly higher than that in normal tissues (AOD: control group 0.207 + 0.056; 0.347 + 0.054 P0.05 Cancer Group); the expression of M1-PK decreased with the degree of tumor differentiation decreased in the CRC group (AOD: control group 0.320 + 0.026; 0.260 + 0.016 moderately differentiated group; low differentiation group 0.167 + 0.059; P0.05); the expression of M2-PK in CRC tissues increased with the degree of tumor differentiation decreased (AOD: control group 0.207 + 0.056; 0.259 + 0.068 moderately differentiated group; low differentiation group was 0.420 + 0.019; P0.05; 2.) by single factor and multi factor score Analysis and comparison of M1-PK and M2-PK in low differentiation group CRC, display and the relationship between the clinical pathological features of expression differentiation group and normal paracancerous tissues, closely related to the degree of positive expression in CRC tissues and the differentiation of M1-PK (P0.05), and the patient's age, tumor size, tumor location, clinical stage and TNM lymph node expression and tumor size independent.M2-PK in CRC tissues was closely related to metastasis, clinical TNM staging and tumor differentiation (P0.05), and the patient's age, tumor location, whether there is correlation between the expression of M2-PK and lymph node metastasis had no obvious relationship with.3.CRC in the M1-PK group: Using linear correlation analysis the results showed that M1-PK and M2-PK expression of AOD, r=-0.689, P0.01, there was a negative correlation between the tips. Conclusion: both the 1.M1-PK and M2-PK CRC expression in epithelial cells and normal colonic epithelial cells, which is not only a specific One of them,.2.M2-PK expression in CRC cells, can initially reflect tumor size, tumor stage and tumor differentiation..3. indicates from the perspective of tissue expression that M2-PK is positively correlated with the malignancy and progression of human CRC, while M1-PK is negatively correlated with the malignancy and progression of human CRC.

【學(xué)位授予單位】：四川醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R735.34

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相關(guān)期刊論文 前1條

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本文編號(hào)：1588573