本文選題：夜間低氧　切入點(diǎn)：非小細(xì)胞肺癌　出處：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討夜間低氧對中晚期NSCLC患者血清VEGF及Ki67表達(dá)的影響及臨床意義。方法:通過腕式血氧儀監(jiān)測64例經(jīng)組織活檢病理學(xué)初診且未經(jīng)治療的中晚期非小細(xì)胞肺癌患者夜間血氧,依監(jiān)測結(jié)果將患者分為夜間低氧組和非夜間低氧組,免疫組化法檢測兩組肺癌組織Ki67蛋白表達(dá)情況;于治療前抽取空腹靜脈血獲取血清,酶聯(lián)免疫吸附(ELISA)法檢測各組血清血管內(nèi)皮生長因子(Serum vascular endothelial growth factor,sVEGF)的水平。比較兩組Ki67陽性率及sVEGF水平的差異,分析夜間低氧對Ki67陽性率、血清VEGF水平的影響,并討論它們與各項(xiàng)臨床參數(shù)之間的關(guān)系。結(jié)果:1、中晚期NSCLC患者夜間低氧發(fā)生率為45.3%(29/64),血氧水平在兩組間比較存在顯著差異(P=0.000),且在輕、中、重度夜間低氧組間兩兩比較,存在顯著差異(P0.05);夜間低氧與患者年齡、性別、病理類型、TNM分期、遠(yuǎn)處轉(zhuǎn)移情況無相關(guān)性(P0.05),與吸煙(P=0.027)、大體類型(P=0.031)顯著相關(guān),吸煙、中央型肺癌患者夜間低氧發(fā)生率高于不吸煙、周圍型肺癌患者。2、兩組間sVEGF水平、Ki67陽性率的差異有統(tǒng)計學(xué)意義(P=0.00),夜間低氧組sVEGF水平、Ki67陽性率均高于非夜間低氧組。3、sVEGF水平與患者性別、年齡、吸煙、病理類型、大體類型、TNM分期均無相關(guān)性(P0.05),而與遠(yuǎn)處轉(zhuǎn)移顯著相關(guān)(P=0.00),有遠(yuǎn)處轉(zhuǎn)移者高于無遠(yuǎn)處轉(zhuǎn)移者;Ki67陽性率與上述各臨床參數(shù)均無明顯相關(guān)性。4、相關(guān)性分析:Pearson相關(guān)分析顯示sVEGF水平與Ki67陽性率呈正相關(guān)(P0.05)。結(jié)論:1.夜間低氧可促進(jìn)中晚期NSCLC患者sVEGF和Ki67的表達(dá)。2.NSCLC患者sVEGF明顯升高提示可能存在遠(yuǎn)處轉(zhuǎn)移。3.NSCLC患者Ki67陽性率與sVEGF呈正相關(guān),可能在肺癌的發(fā)生發(fā)展過程中起協(xié)同作用。
[Abstract]:Objective: to investigate the effect and clinical significance of nocturnal hypoxia on the expression of serum VEGF and Ki67 in patients with advanced NSCLC. Methods: 64 cases of non-small cell lung, newly diagnosed and untreated by histopathology, were monitored by wrist oxygenator. Cancer patients' nocturnal blood oxygen, Patients were divided into nocturnal hypoxia group and non-nocturnal hypoxia group according to the monitoring results. Immunohistochemical method was used to detect the expression of Ki67 protein in lung cancer tissues. The serum levels of vascular endothelial growth factor Serum vascular endothelial growth factors (VEGF) were detected by Elisa. The difference of Ki67 positive rate and sVEGF level between the two groups was compared, and the effect of nocturnal hypoxia on Ki67 positive rate and serum VEGF level was analyzed. Results the incidence of nocturnal hypoxia in the middle and late stage of NSCLC was 45.33 / 64%. There was a significant difference in blood oxygen level between the two groups, and there was significant difference between the two groups in the nocturnal hypoxia, and there was a significant difference between the light, moderate and severe nocturnal hypoxia groups, and there was a significant difference between the two groups in the nocturnal hypoxia. There was significant difference between nocturnal hypoxia and age, sex, pathological type, TNM stage, distant metastasis (P0.05), but significant correlation with smoking (P0.027), gross type (P0.031). Smoking, the incidence of nocturnal hypoxia in patients with central lung cancer was higher than that in non-smoking patients. The positive rate of sVEGF in peripheral lung cancer patients was significantly higher than that in nocturnal hypoxia group. The positive rate of sVEGF in nocturnal hypoxia group was higher than that in non-nocturnal hypoxia group and the patients' sex, age, smoking and pathological type. There was no significant correlation between TNM staging and distant metastasis (P 0.05), but there was no significant correlation between distant metastasis and distant metastasis. The positive rate of Ki67 in patients with distant metastasis was higher than that in patients without distant metastasis. There was no significant correlation between the positive rate of Ki67 and the clinical parameters mentioned above. The correlation analysis showed that the correlation analysis showed that there was no significant correlation between the positive rate and the clinical parameters mentioned above. Conclusion: 1. Nocturnal hypoxia can promote the expression of sVEGF and Ki67 in middle and late NSCLC patients. 2. The increase of sVEGF in NSCLC patients suggests that there may be distant metastasis. 3. Ki67 positive rate in NSCLC patients is positively correlated with sVEGF. It may play a synergistic role in the occurrence and development of lung cancer.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R734.2

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