本文選題：非小細胞肺癌 + EGFR基因型　； 參考：《石河子大學(xué)》2017年碩士論文

【摘要】：目的:探討PD-1在非小細胞肺癌中表皮生長因子EGFR基因檢測不同亞型之間表達的差異性,探討兩者之間的關(guān)系及其表達與非小細胞肺癌浸潤、轉(zhuǎn)移和預(yù)后的關(guān)系。方法:收集新疆軍區(qū)總醫(yī)院共88例非小細胞肺癌患者病理標(biāo)本,取肺癌癌組織和癌旁組織,采用PCR-ARMS測序法檢測標(biāo)本組織的EGFR基因突變亞型,采用免疫組織化學(xué)方法染色來檢測PD-1的表達情況,分析PD-1表達情況在EGFR基因的不同亞型之間的表達程度,并且結(jié)合臨床病理因素進行單因素和COX多因素生存分析。結(jié)果:(1)肺癌組織中PD-1的陽性表達率為63.64%,癌旁組織中PD-1的陽性表達率為21.59%,肺癌組織和癌旁組織間的表達存在差異性(P=0.008)。PD-1陽性表達情況在腫瘤淋巴結(jié)侵犯情況(P=0.010)和是否吸煙(P=0.024)之間的差異存在統(tǒng)計學(xué)意義;PD-1陽性表達情況與患者的性別、年齡、腫瘤直徑分組、腫瘤分化程度、腫瘤浸潤深度、TNM分期之間的差異沒有統(tǒng)計學(xué)意義(P0.05)。(2)EGFR基因檢測結(jié)果:突變型43例,野生型45例,突變率48.86%。肺癌組織中PD-1陽性表達在EGFR突變型野生型之間的差異無統(tǒng)計學(xué)意義(P0.05)。(3)43例突變型患者中19Del突變亞型為24例,PD-1陽性表達為20例,陽性率83.33%,21L858R突變亞型為19例,PD-1陽性表達10例,陽性率52.63%,交叉表分析PD-1在EGFR不同亞型之間的表達差異有統(tǒng)計學(xué)意義(P=0.029)。生存分析結(jié)果提示EGFR野生型中PD-1不同表達的患者生存期差異有統(tǒng)計學(xué)意義(P=0.024),EGFR突變型中PD-1不同表達的患者生存期差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:(1)肺癌組織中PD-1蛋白的表達較癌旁組織明顯增高,PD-1在癌組織中的表達與肺癌的增殖活性和侵襲性有關(guān)。(2)PD-1是預(yù)測肺癌患者生存時間的危險因素,其表達在非小細胞肺癌EGFR突變不同亞型之間存在差異,為19Del和21L858R作為兩種不同類型的肺癌進行研究提供了證據(jù)。
[Abstract]:Objective: to investigate the difference of expression of epidermal growth factor (EGFR) gene in non-small cell lung cancer (NSCLC), and to explore the relationship between EGF EGFR gene expression and invasion, metastasis and prognosis of NSCLC. Methods: the pathological specimens of 88 patients with non-small cell lung cancer were collected from Xinjiang military region General Hospital. PCR-ARMS sequencing was used to detect the mutation subtypes of EGFR gene in lung cancer tissues and adjacent tissues. Immunohistochemical staining was used to detect the expression of PD-1, and the expression of PD-1 among different subtypes of EGFR gene was analyzed. Univariate and COX multivariate survival analysis was performed with clinicopathological factors. Results the positive expression rate of PD-1 was 63.64 in lung cancer and 21.59 in paracancerous tissue. There was a difference between lung cancer and paracancerous tissue. There was statistical significance between the positive expression of PD-1 and the sex of the patients. There was no significant difference in age, tumor diameter, tumor differentiation, tumor invasion depth and TNM stage. The results of EGFR gene detection were as follows: mutation type 43 cases, wild type 45 cases, mutation rate 48.86%. There was no significant difference between PD-1 positive expression and wild type of EGFR mutation in lung cancer. In 43 patients with EGFR mutation, there were 24 cases of 19Del mutation subtype and 20 cases of positive expression of 19Del mutation subtype. The positive rate was 83.33% 21 L858R mutation subtype 19 cases with positive expression of pPD-1 gene, and the positive rate of 19Del mutation subtype 21 L858R mutation was 19 cases with positive expression of pPD-1 in 10 cases. The positive rate was 52.63%. There was significant difference in the expression of PD-1 among different subtypes of EGFR by cross table analysis. Survival analysis showed that the survival time of patients with different expression of PD-1 in wild type of EGFR was significantly different. There was no significant difference in survival time of patients with different expression of PD-1 in EGFR wild type. Conclusion the expression of PD-1 protein in lung cancer tissues is significantly higher than that in adjacent tissues. The expression of PD-1 in lung cancer tissues is related to the proliferative activity and invasiveness of lung cancer, which is a risk factor for predicting the survival time of lung cancer patients. The expression of 19Del and 21L858R were different among different subtypes of EGFR mutation in non-small cell lung cancer (NSCLC), which provided evidence for the study of 19Del and 21L858R as two different types of lung cancer.
【學(xué)位授予單位】：石河子大學(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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本文編號：1784612