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  本文選題：循環(huán)內(nèi)皮細(xì)胞　切入點：腹腔熱灌注化療　出處：《河北大學(xué)》2017年碩士論文

【摘要】：目的:卵巢癌發(fā)病率在全世界女性腫瘤發(fā)病中處在第8位,美國公布的數(shù)據(jù)約有40%的患者可以獲得治愈,是女性婦科腫瘤相關(guān)死亡率最高的因素。但在我國大部分的患者初治時已屬于Ⅲ期,預(yù)后欠佳。目前推薦的治療是腫瘤減滅術(shù)及腹腔熱灌注化療,但此種治療風(fēng)險較大。循環(huán)內(nèi)皮細(xì)胞(CECs)及活化循環(huán)內(nèi)皮細(xì)胞(VCEC)是存在于外周血中的內(nèi)皮細(xì)胞的一種,有實驗表明其隨腫瘤的進展升高,隨有效的治療下降,是預(yù)測腫瘤效果及預(yù)后的一個可觀測的指標(biāo)。本實驗是通過檢測外周血中CECs及VCEC數(shù)目評價單純卵巢熱灌注化療及聯(lián)合恩度腹腔內(nèi)熱灌注化療的效果及其相關(guān)性。方法:應(yīng)用隨機方法將39例患者分為兩組,治療組20例聯(lián)合恩度進行腹腔熱灌注化療,對照組19例應(yīng)用單純腹腔熱灌注化療。在治療前及治療后1周抽取外周血應(yīng)用流式細(xì)胞術(shù)檢測循環(huán)內(nèi)皮細(xì)胞(CECs)及活化循環(huán)內(nèi)皮細(xì)胞(VCEC)。另外于體檢中心抽取健康女性外周血作為陰性對照。觀察:1)對照組治療前、治療組治療前及健康人群CECs及VCEC指標(biāo)及差別;2)對照組與治療組治療后CECs及VCEC指標(biāo)及差別;3)治療組中血性腹水及普通黃綠色腹水治療前后CECs及VCEC差別;4)對照組及治療組抗腫瘤治療療效及其差異。所有的統(tǒng)計數(shù)據(jù)及圖表制作均應(yīng)用SPSS 16.0及EXCEL 2010制作;所有的數(shù)據(jù)選擇表示;所有的統(tǒng)計分析均為雙側(cè)分析,其中P0.05具有統(tǒng)計學(xué)意義;相關(guān)計量數(shù)據(jù)符合正態(tài)分布的采用t檢驗對比,有效率的對比采用卡方檢驗,采用spearman‘s進行相關(guān)性分析。結(jié)果:1.治療前健康組CECs和對照組有明顯差異(p0.001),治療前健康組CECs結(jié)果和治療組有明顯差異(p0.001);治療組和對照組差異無統(tǒng)計學(xué)意義(p=0.658)。治療前健康組v CEC和對照組有明顯差異(p0.001),治療前健康組v CEC與治療組有明顯差異(p0.001),治療組和對照組無顯著差異(p=0.726)。2.對照組治療前CECs與治療后對比,存在差異,治療后CECs水平明顯下降,P0.001。對照組治療前VCEC與治療后對比存在差異,P0.001。治療組治療前CECs與治療后對比,存在差異,P0.001。治療組治療前VCEC與治療后對比,存在差異,治療后v CEC水平明顯下降,P0.001。3.對比血性組(2b+3b)與非血性組(3a+2a)治療前CECs及v CEC差別。血性組及非血性組治療前CECs水平符合正態(tài)分布檢驗,采用兩樣本Student's t test,P值=0.0110.05,差異有統(tǒng)計學(xué)意義。血性組及非血性組治療前VCEC水平對比,P=0.0830.05,差異無統(tǒng)計學(xué)意義。4.治療組RR率80%;對照組RR率78.9%,采用卡方檢驗比較治療組及對照組有效率,P=0.716,無統(tǒng)計學(xué)差異。2a組治療前后CECs與2b組治療前后CECs對比,采用配對T檢驗,P=0.010.05,差異有統(tǒng)計學(xué)意義。2a組治療前后v CEC與2b組治療前后v CEC下降對比采用配對T檢驗,P值=0.0470.05,差異有統(tǒng)計學(xué)意義。3a組治療前后及3b治療前后CECs下降對比采用方差不齊配對T檢驗,P=0.3880.05,差異無統(tǒng)計學(xué)意義,兩組CECs水平下降無差異。3a組治療前后及3b組治療前、后v CEC下降對比采用配對T檢驗,P=0.3030.05,差異無統(tǒng)計學(xué)意義。5.治療前CECs水平與治療效果相關(guān)性的研究采用spearman‘s相關(guān)分析,相關(guān)系數(shù)rs=-0.170,P=0.300,無統(tǒng)計學(xué)意義,無相關(guān)性。治療前VCEC水平與治療效果相關(guān)性的研究采用spearman‘s相關(guān)分析,相關(guān)系數(shù)rs=-0.471,P=0.003,有統(tǒng)計學(xué)意義,呈負(fù)相關(guān)。結(jié)論:1.循環(huán)內(nèi)皮細(xì)胞是觀察卵巢癌伴有惡性腹腔積液患者腹水控制的一個潛在的指標(biāo)。2.腹腔熱灌注治療及恩度聯(lián)合腹腔熱灌注治療是治療卵巢合并腹腔積液一個有效的措施。3.恩度聯(lián)合腹腔熱灌注化療有提高腹腔熱灌注化療有效率的趨勢,無統(tǒng)計學(xué)意義。4.恩度針對血性腹腔積液效果更好,可以得到更好的控制。5.VCEC水平與卵巢癌合并腹腔積液的患者治療效果呈負(fù)相關(guān)。
[Abstract]:Objective: the incidence of ovarian cancer in the pathogenesis of cancer in women around the world in eighth, the United States released data about 40% of patients can be cured, is female gynecological tumor associated with the highest mortality rate in our country. But most of the patients are stage III, good prognosis owe the recommended treatment is at present. Cytoreductive surgery and intraperitoneal hyperthermic perfusion chemotherapy, but the treatment of high risk. The circulating endothelial cells (CECs) and activation of circulating endothelial cells (VCEC) is a present in the peripheral blood endothelial cells, experiments have shown that with the progression of the tumor increased, with the decline of effective treatment, is a the observed index prediction of tumor and prognosis. This experiment is through the number of CECs and VCEC detection in the peripheral blood of IPHP simple ovarian perfusion chemotherapy and evaluate the effect of Endostar and correlation. Methods: using random method 39 patients were divided into two groups, 20 cases in the treatment group combined with Endostar hyperthermic intraperitoneal chemotherapy, 19 cases in the control group used simple peritoneal perfusion chemotherapy. In 1 weeks before and after treatment from peripheral blood flow cytometry was used to detect circulating endothelial cells (CECs) and activation of circulating endothelial cells (VCEC in addition to the physical examination center.) from peripheral blood of healthy women as negative control. Observe: 1) control group before treatment, the treatment group before treatment and healthy population CECs and VCEC index and difference; 2) the control group and the treatment group after the treatment of CECs and VCEC index and difference; 3) in the treatment group before and after hemorrhagic ascites and ordinary yellow green CECs and VCEC differential treatment of ascites; 4) group and treatment group curative effect of anti-tumor therapy and the difference of control. All of the statistical data and charts are used in SPSS 16 and EXCEL 2010; all data representation; all statistical analyses were two-sided analysis P0.05, which has statistical significance; the relevant measurement data with normal distribution by t test comparison, comparing the efficiency of using the chi square test, using Spearman 's correlation analysis. Results: 1. healthy before treatment group CECs and control group had significant difference (p0.001) before treatment, CECs treatment group and healthy group results there was significant difference (p0.001); the treatment group and the control group had no significant difference (p=0.658) before treatment. V healthy group CEC and control group had significant difference (p0.001), V CEC health group before treatment and the treatment group had significant difference (p0.001), there was no significant difference between the treatment group and the control group (p=0.726.2.) the control group before treatment and after treatment CECs comparison, there are differences, the level of CECs decreased significantly after treatment, P0.001. group before treatment and after treatment of the existence of differences between VCEC, P0.001. treatment group before and after treatment CECs comparison, differences in P0.001. treatment group Compared with before treatment, after the treatment with VCEC differences, V CEC levels were significantly decreased after treatment, compared with P0.001.3. group (2b+3b) and non hemorrhagic hemorrhagic group (3a+2a) and V CEC CECs before treatment difference. Hemorrhagic group and non hemorrhagic group CECs level before treatment with normal distribution test, using two sample Student's t test. P =0.0110.05, the difference was statistically significant. Blood group and non hemorrhagic group comparison, VCEC level before P=0.0830.05, there was no significant difference between.4. treatment group RR was 80%; the control group was 78.9% RR, using chi square test to compare the efficiency of the treatment group and the control group, P= 0.716, no significant difference between the groups before and after treatment before and after.2a CECs and CECs in 2B group compared with paired T test, P=0.010.05, the difference has statistical significance before and after treatment in group.2a and group 2B before and after V CEC treatment of V CEC decreased compared with paired T test, P value =0.0470.05, the difference has statistical significance before and after treatment in group.3a Before and after treatment of CECs and 3b decreased compared with the homogeneity of variance paired T test, P=0.3880.05, no significant difference between the CECs levels of the two groups decreased there was no difference between group.3a and group 3B before and after treatment before treatment, after V CEC decreased compared with paired T test, P=0.3030.05, of no significant difference between the level of CECs before and.5. treatment. Effect of treatment with Spearman 's correlation analysis, correlation coefficient rs=-0.170, P=0.300, no statistical significance, no correlation. The VCEC level before treatment and treatment effect of correlation with Spearman' s correlation analysis, correlation coefficient rs=-0.471, P=0.003, a statistically significant negative correlation. Conclusion: 1. circulating endothelial cells is observed in the ovary carcinoma with malignant ascites in patients with ascites control is a potential indicator of.2. intraperitoneal hyperthermic perfusion treatment and Endostar combined with intraperitoneal hyperthermic perfusion therapy is a treatment of ovarian complicated with ascites .3. Endostar combined with intraperitoneal hyperthermic perfusion chemotherapy is effective to improve the efficiency of peritoneal perfusion chemotherapy trend, no significant.4. for better effect of Endostar bloody peritoneal effusion, was negatively related to treatment effect can get better control the level of.5.VCEC and ovarian cancer with ascites.

【學(xué)位授予單位】：河北大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.31

【參考文獻】

相關(guān)期刊論文 前9條

1 鄭偉;康靜波;溫居一;王靜;;重組人血管內(nèi)皮抑制素聯(lián)合順鉑對惡性胸腔積液患者VEGF、EGFR及腫瘤標(biāo)志物的影響[J];實用臨床醫(yī)藥雜志;2016年23期

2 秦叔逵;李進;;阿帕替尼治療胃癌的臨床應(yīng)用專家共識[J];臨床腫瘤學(xué)雜志;2015年09期

3 王文武;陳曦;解方為;余宗陽;陳朗;陳雄;歐陽學(xué)農(nóng);;重組人血管內(nèi)皮抑制素聯(lián)合氟尿嘧啶腹腔灌注并配合深部熱療治療惡性腹水的臨床觀察[J];中華臨床醫(yī)師雜志(電子版);2013年15期

4 譚玲;鄭曉君;張志英;;紫杉醇腹腔灌注治療卵巢癌的臨床觀察[J];中國腫瘤臨床與康復(fù);2013年02期

5 黃萬中;蔣華;江繼發(fā);劉倩;;紫杉醇腹腔灌注化療治療晚期卵巢癌臨床研究[J];現(xiàn)代腫瘤醫(yī)學(xué);2012年02期

6 吳窮;秦叔逵;王杰軍;曲文書;殷曉進;陳亞利;華海清;文勇;;重組人血管內(nèi)皮抑制素聯(lián)合順鉑抗血管形成作用的實驗研究[J];臨床腫瘤學(xué)雜志;2008年05期

7 馬冬;;貝伐單抗聯(lián)合依立替康、氟尿嘧啶/甲酰四氫葉酸對轉(zhuǎn)移性結(jié)直腸癌的治療[J];循證醫(yī)學(xué);2006年05期

8 王金萬,孫燕,劉永煜,于起濤,張沂平,李凱,朱允中,周清華,侯梅,管忠震,李維廉,莊武,王東林,梁后杰,秦鳳展,盧輝山,劉曉晴,孫紅,張燕軍,王杰軍,羅素霞,楊瑞合,涂遠(yuǎn)榮,王秀問,宋恕平,周靜敏,游麗芬,王競,姚晨;重組人血管內(nèi)皮抑素聯(lián)合NP方案治療晚期NSCLC隨機、雙盲、對照、多中心Ⅲ期臨床研究[J];中國肺癌雜志;2005年04期

9 吳素芳;謝優(yōu)優(yōu);陳佩芳;;重組人血管內(nèi)皮抑制素聯(lián)合靜脈化療和腹腔熱灌注化療治療晚期卵巢癌的臨床研究[J];中國醫(yī)師進修雜志;2013年03期

，

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