本文選題：卵巢癌 + 子宮內(nèi)膜癌　； 參考：《西南交通大學(xué)》2017年碩士論文

【摘要】：目前婦科惡性腫瘤已經(jīng)成為主要威脅女性生命的重要?dú)⑹?其中卵巢癌、子宮內(nèi)膜癌和子宮頸癌的發(fā)病率最高,且發(fā)病日益趨向年輕化。由于缺乏有效的早期發(fā)現(xiàn)及治療手段,婦科惡性腫瘤已成為不容忽視的嚴(yán)重威脅女性健康的頭等大事。近年來(lái)研究發(fā)現(xiàn),由多種細(xì)胞(包括腫瘤細(xì)胞)分泌到細(xì)胞外基質(zhì)的主要成分透明質(zhì)酸,參與細(xì)胞的定位、遷移,并涉及腫瘤細(xì)胞的運(yùn)動(dòng)與增殖,因此,目前普遍認(rèn)為,透明質(zhì)酸與腫瘤發(fā)生發(fā)展關(guān)系密切。本研究選取44份卵巢癌、39份子宮內(nèi)膜癌和35份宮頸癌共計(jì)118位婦科惡性腫瘤患者的部分術(shù)后病理檢查、免疫組化分析、血清腫瘤標(biāo)志物(CA125、CA199、SCC和HE4)檢測(cè)結(jié)果以及全部118份婦科惡性腫瘤患者血清透明質(zhì)酸含量測(cè)定結(jié)果,用生物統(tǒng)計(jì)學(xué)方法,對(duì)卵巢癌、子宮內(nèi)膜癌和宮頸癌患者的部分術(shù)后病理檢查、免疫組化分析、血清腫瘤標(biāo)志物與血清中透明質(zhì)酸含量相關(guān)性進(jìn)行分析,獲得以下研究結(jié)果:20份婦科非惡性腫瘤患者血清中透明質(zhì)酸平均值為189.15±48.029ng/ml;與婦科非惡性腫瘤患者血清透明質(zhì)酸含量比較,卵巢癌和子宮內(nèi)膜癌患者血清中透明質(zhì)酸含量均值分別為293.75±173.08 ng/mL和239.57±61.70 ng/mL,達(dá)到了差異極顯著(P0.01),而宮頸癌患者血清中透明質(zhì)酸含量237.30±118.01 ng/mL則無(wú)顯著差異。對(duì)卵巢癌、子宮內(nèi)膜癌和宮頸癌婦科惡性腫瘤患者癌癥淋巴轉(zhuǎn)移、分化程度、臨床分期與血清中透明質(zhì)酸含量相關(guān)性分析結(jié)果顯示:在檢測(cè)所分析樣本中,與婦科非惡性腫瘤患者血清中透明質(zhì)酸含量比較,無(wú)癌淋巴轉(zhuǎn)移患者血清中透明質(zhì)酸含量存在顯著差異(P0.05),而癌淋巴轉(zhuǎn)移者則達(dá)到了極顯著差異(P0.01),表明卵巢癌、子宮內(nèi)膜癌和宮頸癌婦科惡性腫瘤患者淋巴轉(zhuǎn)移與否與患者血清中透明質(zhì)酸含量升高呈現(xiàn)出顯著正相關(guān)。卵巢癌患者血清中透明質(zhì)酸含量與卵巢癌分化高低沒(méi)有顯著差異;子宮內(nèi)膜癌患者血清中透明質(zhì)酸含量與子宮內(nèi)膜癌分化高低有顯著差異(P0.01);宮頸癌患者血清中透明質(zhì)酸含量只有在中和中高分化程度才與婦科非惡性患者血清中透明質(zhì)酸含量存在顯著差異(P0.05)。卵巢癌和子宮內(nèi)膜癌患者血清中透明質(zhì)酸含量隨臨床分期不同存在顯著差異(P0.05),但宮頸癌患者血清中透明質(zhì)酸含量與臨床分期無(wú)關(guān)。按血清腫瘤標(biāo)志物CA125診斷指標(biāo)臨界值35 U/mL,CA19-9診斷指標(biāo)臨界值37 U/mL,HE4診斷指標(biāo)臨界值150 pmol/L,SCC診斷指標(biāo)臨界值1.5 ng/mL的判斷標(biāo)準(zhǔn),對(duì)卵巢癌、子宮內(nèi)膜癌和宮頸癌三種婦科惡性腫瘤患者血清中腫瘤標(biāo)志物與透明質(zhì)酸含量相關(guān)性分析結(jié)果顯示:卵巢癌患者血清腫瘤標(biāo)志物CA125、HE4和CA19-9檢測(cè)結(jié)果與實(shí)際病理診斷結(jié)果準(zhǔn)確率分別為95.45%、50%和27.27%。進(jìn)一步分析卵巢癌患者血清腫瘤標(biāo)志物CA19-9和HE4檢測(cè)陰性的患者血清中透明質(zhì)酸含量,與婦科非惡性腫瘤患者血清中透明質(zhì)酸含量比較,其差異分別到達(dá)顯著(P0.05)和極顯著(P0.01)水平,表明卵巢癌患者血清中透明質(zhì)酸檢測(cè)可能比腫瘤標(biāo)志物CA19-9和HE4檢測(cè)更敏感。子宮內(nèi)膜癌患者血清腫瘤標(biāo)志物CA125和CA19-9檢測(cè)結(jié)果與實(shí)際病理診斷結(jié)果準(zhǔn)確率分別為42.86%和32.43%,但子宮內(nèi)膜癌血清腫瘤標(biāo)志物CA125和CA19-9陰性患者的血清中透明質(zhì)酸含量,與婦科非惡性腫瘤患者血清中透明質(zhì)酸含量比較,分別到達(dá)顯著(P0.05)和極顯著(P0.01)差異,表明子宮內(nèi)膜癌患者血清中透明質(zhì)酸檢測(cè)可能比腫瘤標(biāo)志物CA125和CA19-9更敏感。宮頸癌患者血清腫瘤標(biāo)志物SCC檢測(cè)結(jié)果與實(shí)際診斷結(jié)果準(zhǔn)確率為57.14%,只有腫瘤標(biāo)志物SCC檢測(cè)陽(yáng)性的患者血清中透明質(zhì)酸含量,與婦科非惡性腫瘤患者血清中透明質(zhì)酸含量比較才有顯著差異(P0.05)。我們實(shí)驗(yàn)結(jié)果分析表明,檢測(cè)卵巢癌、子宮內(nèi)膜癌婦科惡性腫瘤患者血清中透明質(zhì)酸含量可能比檢測(cè)目前的某些腫瘤標(biāo)志物(如HE4和CA19-9)更敏感,當(dāng)然本研究結(jié)果僅僅是一個(gè)初步,研究的也不夠深入,收集的樣品標(biāo)本也有限,我們的初步結(jié)論還需要進(jìn)一步的深入研究。
[Abstract]:At present, gynecological malignant tumor has become an important killer of female life, among which ovarian cancer, endometrial cancer and cervical cancer have the highest incidence, and the incidence of the disease is becoming increasingly young. Due to the lack of effective early detection and treatment, gynecologic malignant tumor has become a serious threat to women's health. In recent years, it has been found that hyaluronic acid, the main component of a variety of cells (including tumor cells), is secreted to the extracellular matrix, participates in the location and migration of cells, and involves the movement and proliferation of tumor cells. Therefore, it is generally believed that hyaluronic acid is closely related to the development of tumor. 44 ovarian cancer and 39 uterus were selected in this study. Partial postoperative pathological examination, immunohistochemical analysis, serum tumor markers (CA125, CA199, SCC and HE4) and serum hyaluronic acid content in all 118 patients with gynecologic malignant tumor, and the results of serum hyaluronic acid content in all 118 cases of gynecologic malignant tumor, and biostatistical methods for ovarian cancer, endometrial cancer and endometrium cancer. The correlation of postoperative pathological examination, immunohistochemical analysis, serum tumor markers and serum hyaluronic acid content in serum of patients with cervical cancer was analyzed. The following results were obtained: the average value of hyaluronic acid in serum of 20 non malignant gynecologic tumor patients was 189.15 48.029ng/ml, and the serum hyaluronic acid content of the patients with non malignant gynecologic tumor was compared with the serum hyaluronic acid content of the patients with non malignant gynecologic cancer. The serum levels of hyaluronic acid in the patients with ovarian cancer and endometrial carcinoma were 293.75 + 173.08 ng/mL and 239.57 + 61.70 ng/mL respectively, and the difference was very significant (P0.01). There was no significant difference between the serum hyaluronic acid content in the serum of the patients with cervical cancer and 237.30 + 118.01 ng/mL. The correlation analysis of lymph node metastasis, differentiation, clinical stage and serum hyaluronic acid content showed that there was a significant difference in serum hyaluronic acid content in the serum of patients with non malignant tumor of Gynecology, and there was significant difference in serum hyaluronic acid content in the patients with non cancer lymphatic metastasis (P0.05). There was a very significant difference (P0.01), indicating that the lymphatic metastasis of ovarian cancer, endometrial cancer and cervical cancer patients with gynecologic malignancies had a significant positive correlation with the increase of serum hyaluronic acid content in patients with ovarian cancer. The content of hyaluronic acid was significantly different from that of endometrial carcinoma (P0.01). The serum hyaluronic acid content in the sera of the patients with cervical cancer was significantly different from that of the non malignant gynecologic patients (P0.05). The serum hyaluronic acid content in the serum of the patients with ovarian cancer and endometrium carcinoma was associated with the clinical value. There were significant differences in different stages (P0.05), but the serum hyaluronic acid content in the sera of the patients with cervical cancer was not related to the clinical stage. The critical value of the serum tumor marker CA125 diagnostic index was 35 U/mL, the critical value of the CA19-9 diagnostic index, the critical value of the HE4 diagnostic index 150 pmol/L, the critical value of the SCC diagnostic index, 1.5 ng/mL, for the ovarian cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer, the ovary cancer The correlation analysis between the serum tumor markers and hyaluronic acid content in three patients with endometriosis and cervical cancer showed that the accuracy rate of the serum tumor markers CA125, HE4 and CA19-9 and the actual pathological diagnosis of ovarian cancer patients were 95.45%, 50% and 27.27%. were further analyzed for the serum swelling of ovarian cancer patients. The serum hyaluronic acid content of the tumor markers CA19-9 and HE4 negative patients was compared with the serum hyaluronic acid content in the serum of non malignant gynecologic cancer patients. The difference of serum hyaluronic acid reached significant (P0.05) and extremely significant (P0.01) levels, indicating that the serum hyaluronic acid detection in the serum of ovarian cancer patients may be more sensitive than the CA19-9 and HE4 detection of tumor markers. The results of serum tumor markers CA125 and CA19-9 in patients with endometrial cancer were 42.86% and 32.43%, respectively, but the serum hyaluronic acid content in serum of endometrial carcinoma serum tumor markers CA125 and CA19-9 negative patients was compared with the serum hyaluronic acid content in the serum of non malignant gynecologic cancer patients, respectively. The significant (P0.05) and extremely significant (P0.01) differences showed that the serum hyaluronic acid detection in patients with endometrial cancer might be more sensitive than the tumor markers CA125 and CA19-9. The accuracy rate of the serum tumor marker SCC in the patients with cervical cancer and the actual diagnosis was 57.14%, only the serum hyaluronic substance in the patients with positive tumor markers SCC detection was hyaluronic. There is a significant difference between the content of acid and the serum hyaluronic acid content in the serum of non malignant gynecologic cancer patients (P0.05). Our results show that the serum hyaluronic acid content in the serum of patients with ovarian cancer and endometrium cancer may be more sensitive than the detection of some of the present markers of swelling (such as HE4 and CA19-9), of course this study The result is only a preliminary study, and the research is not thorough enough. The samples collected are also limited. Our preliminary conclusions need further in-depth study.

【學(xué)位授予單位】：西南交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.31;R737.33

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 趙學(xué)芬;;宮頸癌的早期檢查及預(yù)防[J];醫(yī)療裝備;2017年02期

2 張愛(ài)民;常艷敏;郝艷萍;;卵巢癌早期檢測(cè)的研究進(jìn)展[J];中國(guó)實(shí)驗(yàn)診斷學(xué);2016年10期

3 陳紅香;隋霜;才仁;王琳;劉江超;古麗加娜提;王芬;沈澤虹;瑪依努爾·尼牙孜;;SCC和Ki67在宮頸鱗癌不同分期的表達(dá)及其關(guān)系[J];甘肅醫(yī)藥;2016年09期

4 呂曉梅;陳濤;張小強(qiáng);王曉華;;血清HE4、CA125、CA199、CA724聯(lián)合檢測(cè)對(duì)卵巢癌早期診斷的臨床價(jià)值探討[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2016年09期

5 龔紅霞;徐明娟;;聯(lián)合檢測(cè)HE4、CA125、CA19-9和CEA在卵巢癌診斷中的應(yīng)用[J];中國(guó)醫(yī)學(xué)前沿雜志(電子版);2015年10期

6 翟婷婷;李翠芬;;血清CA125、CA199、CEA和AFP聯(lián)合診斷卵巢癌的臨床研究[J];現(xiàn)代腫瘤醫(yī)學(xué);2015年09期

7 劉云;杜成;劉文超;;卵巢癌治療新進(jìn)展[J];現(xiàn)代腫瘤醫(yī)學(xué);2015年04期

8 侯娟娟;虎淑妍;劉婷婷;張玲;席維岳;鄭紅軍;潘云燕;;血清腫瘤標(biāo)志物在卵巢癌早期診斷中的臨床價(jià)值[J];中國(guó)免疫學(xué)雜志;2014年08期

9 馮先華;郗娟;;CA125、CA153、CA199和CEA聯(lián)合檢測(cè)在上皮性卵巢癌中的診斷價(jià)值[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2014年14期

10 閔玲;鐘亮星;陳琳娜;鄧粵敏;;血清TSGF、SCC聯(lián)合檢測(cè)在宮頸癌診斷中的應(yīng)用價(jià)值[J];實(shí)用醫(yī)學(xué)雜志;2014年06期

，

本文編號(hào)：1778835