本文選題：LDH-A　切入點(diǎn)：LDH-B　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:本研究旨在通過檢測(cè)乳酸脫氫酶A(LDH-A)和乳酸脫氫酶B(LDH-B)蛋白亞基在皮膚基底細(xì)胞癌(basal cell carcinoma,BCC)及鱗狀細(xì)胞癌(squamous cell carcinoma,SCC)中的表達(dá)情況,初步探討LDH-A和LDH-B在BCC和SCC發(fā)病機(jī)制中的作用及臨床意義。希望能為BCC及SCC在臨床上的預(yù)防、診斷及治療提供新的思路及依據(jù)。方法:收集2011年12月-2016年12月在西南醫(yī)科大學(xué)附屬第一醫(yī)院皮膚科及病理科65例診斷為皮膚基底細(xì)胞癌(BCC)和44例診斷為皮膚鱗狀細(xì)胞癌(SCC)患者的石蠟組織標(biāo)本為實(shí)驗(yàn)組,診斷為正常皮膚組織的病例20例作為對(duì)照組,采用免疫組織化學(xué)Maxvision法分別對(duì)65例BCC標(biāo)本、44例SCC標(biāo)本和20例正常皮膚標(biāo)本進(jìn)行LDH-A和LDH-B蛋白的檢測(cè),通過光學(xué)顯微鏡觀察免疫組化的表達(dá)情況,采用免疫組化半定量法分析結(jié)果,采用統(tǒng)計(jì)學(xué)方法進(jìn)行數(shù)據(jù)分析。結(jié)果:1.與正常皮膚組織相比,LDH-A和LDH-B在BCC和SCC組織中的陽性表達(dá)情況顯著升高(P0.05)。LDH-A的表達(dá):65例BCC中,有42例呈陽性表達(dá),陽性率為64.6%。在44例SCC中,有40例呈陽性表達(dá),陽性率為90.9%。在20例正常組織中有3例陽性表達(dá),陽性率為15%;LDH-B的表達(dá):在65例BCC中,有55例呈陽性表達(dá),陽性率為84.6%。在44例SCC中,有37例呈陽性表達(dá),陽性率為84.1%。在20例正常組織中有2例呈陽性表達(dá),陽性率為10.0%。2.LDH-A蛋白在SCC中的陽性表達(dá)程度高于BCC中的表達(dá)(P0.05),LDH-B在BCC和SCC之間的陽性表達(dá)程度,經(jīng)統(tǒng)計(jì)學(xué)分析后無顯著差異(P0.05)。3.LDH-A在低分化的SCC陽性表達(dá)程度強(qiáng)于高分化SCC(P0.05)。LDH-A的表達(dá)在未分化型BCC中的表達(dá)程度強(qiáng)于分化型BCC(P0.05)。LDH-A在高分化類SCC中表達(dá)情況:陽性表達(dá)率為85%,其中,弱陽性表達(dá)率45.0%、中等陽性表達(dá)15.0%、強(qiáng)陽性表達(dá)25.0%;LDH-A在低分化類SCC中表達(dá)情況:陽性表達(dá)率95.8%,其中,弱陽性表達(dá)4.2%、中等陽性表達(dá)20.8%、強(qiáng)陽性表達(dá)70.8%;LDH-A在分化類BCC中的表達(dá)情況:陽性表達(dá)率為46.7%,其中,弱陽性表達(dá)率30.0%、中等陽性表達(dá)率10.0%、強(qiáng)陽性表達(dá)率6.7%;LDH-A在未分化類BCC中的表達(dá)情況:LDH-A蛋白陽性表達(dá)率為80.0%,其中,弱陽性表達(dá)率11.4%、中等陽性表達(dá)率37.2%、強(qiáng)陽性表達(dá)率31.4%。4.LDH-B在低分化類SCC陽性表達(dá)程度低于高分化SCC(P0.05)。LDH-B的表達(dá)在未分化類BCC組織中的表達(dá)程度低于分化類BCC(P0.05)。LDH-B在高分化類SCC中的表達(dá)情況:陽性表達(dá)率為95.0%,其中,弱陽性表達(dá)5.0%、中等陽性表達(dá)40.0%、強(qiáng)陽性表達(dá)50.0%;LDH-B在低分化類SCC中表達(dá)情況:陽性表達(dá)率為75.0%,其中,弱陽性表達(dá)45.8%、中等陽性表達(dá)20.8%、強(qiáng)陽性表達(dá)8.4%;LDH-B在分化類BCC中的表達(dá)情況:陽性表達(dá)率為93.7%,其中,弱陽性表達(dá)率6.7%、、中等陽性表達(dá)率36.6%、強(qiáng)陽性表達(dá)率50.0%;LDH-B在未分化類BCC中的表達(dá)情況:陽性表達(dá)率77.1%,其中,弱陽性表達(dá)率45.7%、中等陽性表達(dá)率22.9%、強(qiáng)陽性表達(dá)率8.5%。5.經(jīng)統(tǒng)計(jì)學(xué)分析,LDH-A和LDH-B的表達(dá)水平在BCC及SCC之間不存在相關(guān)性(P0.05)。結(jié)論:1.LDH-A和LDH-B在皮膚BCC和SCC中高表達(dá),提示LDH-A和LDH-B可能與皮膚基底細(xì)胞癌和鱗狀細(xì)胞癌的發(fā)生發(fā)展有關(guān)。2.LDH-A在皮膚SCC和BCC中的表達(dá)隨惡性程度增高而增強(qiáng),而LDH-B隨SCC和BCC惡性程度的增高而降低,提示LDH-A可能會(huì)促進(jìn)SCC和BCC的發(fā)生發(fā)展,LDH-B可能會(huì)抑制SCC和BCC的發(fā)生發(fā)展。3.LDH-A和LDH-B有希望成為SCC和BCC良好的腫瘤標(biāo)志物。
[Abstract]:Objective: This study aims to detect lactate dehydrogenase A (LDH-A) and lactate dehydrogenase (LDH-B) B protein subunits in basal cell carcinoma (basal cell, carcinoma, BCC) and squamous cell carcinoma (squamous cell, carcinoma, SCC) expression in the role of LDH-A and LDH-B in BCC and SCC in the pathogenesis of and the clinical significance. The hope for BCC and SCC in clinical prevention, provide ideas and new basis of diagnosis and treatment. Methods: from December 2011 December -2016 year in the Southwest Medical University Department of Dermatology and pathology department of the First Affiliated Hospital of 65 cases of diagnosis of basal cell carcinoma (BCC) and 44 cases were diagnosed as squamous cell carcinoma (SCC) patients with paraffin embedded tissue specimens of the experimental group, diagnosed as normal skin tissues of 20 cases as control group, respectively in 65 cases of BCC were detected by Maxvision immunohistochemical method in 44 cases of SCC specimens and 20 cases of normal skin mark The detection of LDH-A and LDH-B protein, through the optical microscope immunohistochemical expression by immunohistochemical analysis, the results of semi quantitative method, using statistical methods for data analysis. Results: 1. compared with normal skin, LDH-A and LDH-B in BCC and SCC in tissue of positive expression increased significantly (P0.05) the expression of.LDH-A: 65 BCC cases, 42 cases were positive, the positive rate of 64.6%. in 44 SCC cases, 40 cases were positive, the positive rate of 90.9%. in 20 cases of normal tissue in 3 cases of positive expression, the positive rate was 15%; the expression of LDH-B: in 65 BCC cases. There are 55 cases with a positive expression. The positive rate of 84.6%. in 44 SCC cases, 37 cases were positive, the positive rate of 84.1%. in 20 cases of normal tissue in 2 cases were positive, the positive rate of positive expression of 10.0%.2.LDH-A protein in SCC was higher than that in BCC (P0.05), LDH-B BCC And among the SCC positive expression level, there were no statistically significant differences by analysis of (P0.05).3.LDH-A in poorly differentiated positive expression of SCC was stronger than that of high differentiated SCC (P0.05).LDH-A expression in undifferentiated type expression level in BCC in differentiated BCC (P0.05).LDH-A expression in differentiated SCC the positive expression rate was 85%, among them, the weak positive expression rate of 45%, 15% moderate positive expression, strong positive expression in 25%; the expression of LDH-A in poorly differentiated SCC positive expression rate was 95.8%, among them, 4.2% weak positive, moderate positive expression of 20.8%, 70.8% strong positive expression; the expression of LDH-A in differentiation of BCC the positive expression rate was 46.7%, among them, the weak positive expression rate was 30%, moderate positive expression rate was 10% and the strong positive expression rate was 6.7%; the expression of LDH-A in undifferentiated class in BCC: the expression rate of LDH-A was 80%, among them, the weak positive expression rate was 11.4%, in Positive expression rate is 37.2%. The strong positive expression rate of 31.4%.4.LDH-B in low differentiation SCC positive expression level is lower than that of high differentiated SCC (P0.05) expression level of.LDH-B expression in undifferentiated BCC tissues differentiation than BCC (P0.05).LDH-B expression in differentiated class in SCC: the positive expression rate of 95%, among them 5%, weak positive, moderate positive expression of 40%, 50% strong positive expression; the expression of LDH-B in poorly differentiated SCC positive expression rate was 75%, among them, 45.8% weak positive, moderate positive expression of 20.8%, 8.4% strong positive expression; the expression of LDH-B in differentiation of class in BCC: the positive expression rate was 93.7%. Among them, weak positive expression rate was 6.7%, the positive expression rate of 36.6%, moderate, strong positive expression rate was 50%; the expression of LDH-B in undifferentiated type BCC: the positive expression rate of 77.1%, among them, the weak positive expression rate was 45.7%, moderate positive expression rate is 22.9%, the strong positive The expression rate of 8.5%.5. by statistical analysis, the expression level of LDH-A and LDH-B there was no correlation between BCC and SCC (P0.05). Conclusion: 1.LDH-A and LDH-B are highly expressed in the skin BCC and SCC, LDH-A and LDH-B may suggest the occurrence and development of skin basal cell carcinoma and squamous cell carcinoma of the expression of SCC and.2.LDH-A in skin off in BCC with malignant degree increased, while LDH-B increased with the malignant degree of SCC and BCC decreased, suggesting that LDH-A may promote the occurrence and development of SCC and BCC, SCC and LDH-B may inhibit the occurrence and development of BCC.3.LDH-A and LDH-B SCC and BCC to become a good tumor marker.

【學(xué)位授予單位】：西南醫(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)】：R739.5

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