本文選題：肺癌　切入點(diǎn)：組織分級(jí)　出處：《河北醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究整合素αvβ3及CD44在肺癌和肺癌骨轉(zhuǎn)移組織中表達(dá)情況,分析二者表達(dá)的相關(guān)性,探討其與肺癌患者的年齡、性別、腫瘤大小以及分化程度等臨床病理特征的關(guān)系。方法:選擇2007年1月至2013年1月在河北醫(yī)科大學(xué)第四醫(yī)院病理科55例肺癌和肺癌骨轉(zhuǎn)移灶患者石蠟標(biāo)本,其中原發(fā)性肺癌30例,骨轉(zhuǎn)移肺癌25例,另取10例癌旁肺組織石蠟標(biāo)本做為對(duì)照組。患者男性36例,女性19例;患者年齡中位數(shù)55歲。采用免疫組織化學(xué)SP法檢測(cè)腫瘤組織中整合素αvβ3、CD44的表達(dá)狀況,并進(jìn)一步分析整合素αvβ3及CD44的表達(dá)與肺癌患者年齡、性別、腫瘤大小、分化程度的相關(guān)性。結(jié)果:1整合素αvβ3在正常肺組織中不表達(dá),在原發(fā)型肺癌及肺癌骨轉(zhuǎn)移組織中呈現(xiàn)高表達(dá)。其中肺癌及肺癌骨轉(zhuǎn)移灶中存在整合素αvβ3的表達(dá),陽(yáng)性率89.1%。肺癌骨轉(zhuǎn)移組中整合素αvβ3的陽(yáng)性率較原發(fā)肺癌組高,陽(yáng)性率分別為96.0%和83.3%。組間多重比較發(fā)現(xiàn),正常肺組織與原發(fā)型肺癌及肺癌骨轉(zhuǎn)移組織之間整合素αvβ3的表達(dá)差異均具有統(tǒng)計(jì)學(xué)意義(P0.001),原發(fā)型肺癌組織與肺癌骨轉(zhuǎn)移組織之間整合素αvβ3的表達(dá)差異也具有統(tǒng)計(jì)學(xué)意義(P0.05)。另外,直徑小于等于3cm與直徑大于3cm肺癌組織中整合素αvβ3陽(yáng)性表達(dá)量的差異無統(tǒng)計(jì)學(xué)意義(P0.05)。男性與女性肺癌患者的整合素αvβ3陽(yáng)性表達(dá)量的差異無統(tǒng)計(jì)學(xué)意義(P0.05);55歲以下與55歲以上患者的整合素αvβ3的陽(yáng)性表達(dá)量無顯著差異(P0.05)。2 CD44在正常肺組織中不表達(dá),在原發(fā)型肺癌及肺癌骨轉(zhuǎn)移組織中呈現(xiàn)高表達(dá)。其中在肺癌及肺癌骨轉(zhuǎn)移灶組織中存在陽(yáng)性表達(dá),陽(yáng)性率為85.5%。肺癌骨轉(zhuǎn)移組中CD44的陽(yáng)性率為92%,較原發(fā)肺癌的陽(yáng)性率80%高。組間多重比較,正常肺組織與原發(fā)型肺癌及肺癌骨轉(zhuǎn)移組織之間CD44的表達(dá)差異均具有統(tǒng)計(jì)學(xué)意義(P0.001),原發(fā)型肺癌組織與肺癌骨轉(zhuǎn)移組織之間CD44的表達(dá)差異也具有統(tǒng)計(jì)學(xué)意義(P0.05)。另外,直徑大于3cm肺癌組織中CD44的陽(yáng)性率與直徑小于等于3cm者的陽(yáng)性率差異不大,經(jīng)統(tǒng)計(jì)學(xué)分析亦無統(tǒng)計(jì)學(xué)意義(P0.05)。肺癌男性與女性患者中CD44的陽(yáng)性表達(dá)量無顯著性差異(P0.05);55歲以下及以上患者中CD44的陽(yáng)性表達(dá)量亦無顯著性差異(P0.05)。3肺癌高分化、中分化和低分化組中整合素αvβ3的陽(yáng)性率分別為87.5%、88.9%和100.0%,組間多重比較得出,高分化組與中分化組以及中分化組與低分化組之間差異無統(tǒng)計(jì)學(xué)意義(P0.05),高分化組與低分化組之間差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。4 CD44分子在肺癌高分化、中分化和低分化組中的陽(yáng)性率分別為68.8%、83.3%和100.0%,組間多重比較發(fā)現(xiàn),高分化組與中分化組之間差異無統(tǒng)計(jì)學(xué)意義(P0.05),中分化組與低分化組之間差異具有統(tǒng)計(jì)學(xué)意義(P0.05),高分化組與低分化組之間差異具有明顯統(tǒng)計(jì)學(xué)意義(P0.001)。5 Spearman相關(guān)分析顯示:整合素αvβ3和CD44蛋白在肺癌組織中的表達(dá)呈正相關(guān)(P0.001)。結(jié)論:1肺癌組織中整合素αvβ3和CD44的陽(yáng)性強(qiáng)度明顯高于正常肺組織;2肺癌骨轉(zhuǎn)移組織中整合素αvβ3和CD44的陽(yáng)性強(qiáng)度高于原發(fā)肺癌;3隨著肺癌組織分化程度的降低,整合素αvβ3和CD44的表達(dá)率呈逐級(jí)上升趨勢(shì);4整合素αvβ3和CD44均可能能夠促進(jìn)肺癌的骨轉(zhuǎn)移,并與腫瘤的惡性程度及預(yù)后密切相關(guān),對(duì)判斷肺癌的預(yù)后具有一定價(jià)值。
[Abstract]:Objective: to research the expression of integrin alpha v beta 3 and CD44 metastasis in lung cancer and lung cancer in bone tissue, correlation analysis of the expression of the two lung cancer patients, and to explore their age, sex, relationship between clinical and pathological features of tumor size and differentiation. Methods: from January 2007 to January 2013 in the Department of Pathology, the fourth hospital of Hebei Medical University in 55 cases metastasis of lung cancer and lung cancer patients with bone tumor specimens, including 30 cases of primary lung cancer and bone metastasis of lung cancer in 25 cases, another 10 cases of adjacent lung tissue specimens as the control group. 36 cases were male, 19 cases of female patients; median age was 55 years old. The tumor tissue was detected by immunohistochemical SP method. Integrin alpha v beta 3, the expression of CD44, and further analysis of integrin alpha v beta expression in patients with lung cancer and 3 age, CD44 and gender, tumor size, differentiation degree of correlation. Results: 1 integrin alpha v beta 3 in normal lung group No expression of tissues showed high expression in primary lung cancer and metastasis of lung cancer bone. The lung cancer and lung cancer bone metastasis in integrin alpha v beta 3 expression, the positive rate of 89.1%. lung cancer bone metastasis integrin alpha v beta 3 compared with primary lung cancer group, the positive rate was 96% and 83.3%. multiple comparisons between groups were found differentially expressed between normal lung tissue and tissue metastasis of primary lung cancer and lung cancer bone integrin alpha v beta 3 were statistically significant (P0.001), differential expression between primary lung cancer and bone metastasis of lung cancer tissue integrin alpha v beta 3 also has statistical significance (P0.05) in addition. And the diameter is less than or equal to the difference between 3cm and diameter greater than 3cm in lung cancer tissue integrin alpha v beta 3 expression was not statistically significant (P0.05). There was no significant difference between male and female patients with lung cancer integrin alpha v beta 3 positive expression (P0.05); 55 There was no significant difference between the positive expression of the patients under the age and over the age of 55 integrin alpha v beta 3 volume (P0.05).2 CD44 was not expressed in normal lung tissue, showed high expression in metastatic tissue in primary lung cancer and lung cancer. The positive expression of bone metastasis in presence of lung cancer and lung cancer bone tumors, the positive rate was the positive rate of CD44 85.5%. of bone metastasis in lung cancer group was 92%, the positive rate of 80% compared with primary lung cancer. Multiple comparisons between groups, the difference between the expression of CD44 in metastatic tissue of normal lung tissue and primary lung cancer and lung cancer bone were statistically significant (P0.001), the difference between the expression of CD44 in primary lung cancer metastasis lung cancer and bone also has statistical significance (P0.05). In addition, the positive rate difference between the positive rate and the diameter of less than or equal to 3cm in diameter greater than CD44 3cm in lung cancer is also no statistical significance by statistical analysis (P0.05) and male lung cancer. There was no significant difference between the positive expression of CD44 in female patients (P0.05); there was no difference of positive expression of CD44 below and above the age of 55 in patients with lung cancer (P0.05).3 positive rate in high differentiation, differentiation and low differentiation group of integrin alpha v beta 3 were 87.5%, 88.9% and 100%. Multiple comparisons between groups showed that there was no significant difference between well differentiated and moderately differentiated group and middle differentiation group and low differentiation group (P0.05), the difference was statistically significant between the highly and poorly differentiated groups (P0.05).4 CD44 in lung cancer with high positive rate of differentiation, differentiation and low differentiation group respectively. As of 68.8%, 83.3% and 100%, multiple comparisons between groups showed that there was no significant difference between well differentiated and moderately differentiated group (P0.05), the difference was statistically significant between the middle differentiation group and low differentiation group (P0.05), the difference between the highly and poorly differentiated groups is significant Statistically significant (P0.001).5 Spearman correlation analysis showed that: there was a positive correlation between the expression of integrin alpha v beta 3 and CD44 protein in non-small cell lung cancer (P0.001). Conclusion: the strength of the 1 positive lung cancer integrin alpha v beta 3 and CD44 was significantly higher than that in normal lung tissue; 2 positive intensity of bone metastasis in lung cancer tissues of integrin V beta 3 and CD44 higher than that of primary lung cancer; 3 with lower lung cancer tissue differentiation, the expression of integrin alpha v beta 3 and CD44 rate showed a gradual upward trend; 4 integrin alpha v beta 3 and CD44 could promote lung cancer bone metastasis, malignant degree and prognosis of tumor and is closely related with a certain value in judging the prognosis of lung cancer.

【學(xué)位授予單位】：河北醫(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)】：R734.2

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