本文選題：胃腫瘤　切入點(diǎn)：Lauren分型　出處：《皖南醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本文通過免疫組化(immunohistochemistry,IHC)以及熒光原位雜交(fluorescence in situ hybridization,FISH)方法檢測(cè)人類表皮生長因子受體2(human epidermal growth factor receptor-2,HER-2)在不同Lauren分型胃癌患者中的表達(dá)情況,分析研究HER-2表達(dá)情況與不同胃癌患者的臨床病理特征以及預(yù)后關(guān)系,以期對(duì)指導(dǎo)不同胃癌患者的治療起到個(gè)體化幫助作用。方法:收集2012年3月至2013年12月在皖南醫(yī)學(xué)院第一附屬醫(yī)院經(jīng)診治并且病理證實(shí)為胃癌的276例患者的病理資料,并對(duì)其進(jìn)行回顧性分析。通過IHC以及FISH技術(shù)判定所有不同患者胃癌組織中的HER-2表達(dá)情況,分析研究HER-2表達(dá)情況與不同胃癌患者臨床病理特征及預(yù)后的關(guān)系,包括與不同Lauren分型胃癌患者的臨床病理特征之間的關(guān)系。結(jié)果:將276例不同Lauren分型胃癌患者的蠟塊標(biāo)本按照IHC方法聯(lián)合FISH方法測(cè)定其HER-2的表達(dá)狀況,陽性率為16.7%(46/276)。HER-2陽性胃癌患者與HER-2陰性者在腫瘤最大徑、T分期、N分期、TNM分期以及Lauren分型方面的差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。HER-2陽性胃癌患者的腫瘤最大徑≥4cm的患者比例高于HER-2陰性者(67.4%/50%,P=0.031);HER-2陽性胃癌患者的浸潤深度未突破臟層腹膜的患者比例顯著低于HER-2陰性者(19.6%/56.5%),而侵及漿膜外的比例顯著高于HER-2陰性者(80.4%/43.5%);HER-2陽性胃癌患者無淋巴結(jié)轉(zhuǎn)移比例顯著低于HER-2陰性者(15.2%/43.9%);HER-2陽性胃癌患者TNM分期中,IV期患者比例顯著高于HER-2陰性者(19.6%/2.2%)。HER-2表達(dá)為陽性的胃癌患者中,Lauren分型為腸型胃癌患者的比例高于彌漫型胃癌患者(80.4%/52.2%,P=0.002)。276例胃癌患者的HER-2陽性率是16.7%(46/276),其中腸型胃癌的HER-2陽性率是23.6%(37/157),而彌漫型胃癌及混合型胃癌患者的HER-2陽性率依次為7.1%(6/84)和8.6%(3/35),三者具有統(tǒng)計(jì)學(xué)差異(P0.05)。單因素生存分析顯示:腫瘤最大徑、腫瘤部位、T分期、N分期、TNM分期、Lauren分型以及HER-2狀態(tài)是影響胃癌患者預(yù)后的相關(guān)因素。多因素生存分析表明:僅腫瘤部位、T分期、N分期、TNM分期和Lauren分型是胃癌患者預(yù)后的獨(dú)立影響因素。生存函數(shù)顯示:HER-2陽性的胃癌患者3年生存率低于HER-2陰性者(28.3%/48.7%,χ2=6.603,P=0.01)。結(jié)論:HER-2的表達(dá)情況與Lauren分型胃癌的臨床病理特征及預(yù)后關(guān)系密切。HER-2陰性的Lauren分型胃癌患者預(yù)后要好于HER-2陽性者。
[Abstract]:Objective: to detect the expression of human epidermal growth factor receptor 2human epidermal growth factor receptor-2HER-2 in patients with different Lauren types of gastric cancer by immunohistochemistry and fluorescence in situ hybridization in situ hybridization (fish). To study the relationship between the expression of HER-2 and the clinicopathological features and prognosis of different gastric cancer patients. Methods: from March 2012 to December 2013, we collected the pathological data of 276 patients with gastric cancer who were diagnosed and treated in the first affiliated Hospital of Southern Anhui Medical College and pathologically proved to be gastric cancer. The expression of HER-2 was determined by IHC and FISH techniques, and the relationship between the expression of HER-2 and the clinicopathological features and prognosis of different gastric cancer patients was studied. Results: the expression of HER-2 in 276 cases of gastric cancer with different Lauren typing was determined by IHC combined with FISH method, including the relationship between the clinicopathological features and the clinicopathological characteristics of gastric cancer patients with different Lauren typing. The positive rate of 46 / 276U 路HER-2 positive gastric cancer patients and HER-2 negative patients were significantly higher than those of HER-2 negative patients. There were statistically significant differences in TNM staging and Lauren classification between patients with HER-2 positive gastric cancer and those with positive gastric cancer P0.05. HER-2 positive patients were higher than those with positive gastric cancer patients with tumor maximum diameter 鈮，

本文編號(hào)：1636951