本文選題：促泌素 + 嗜鉻粒蛋白A��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:通過檢測(cè)促泌素(SCGN)和嗜鉻粒蛋白A(Cg A)在胃腸胰神經(jīng)內(nèi)分泌腫瘤(GEP-NEN)石蠟包埋組織中的表達(dá),探討SCGN在GEP-NEN中的臨床意義以及作為神經(jīng)內(nèi)分泌腫瘤標(biāo)志物用于早期診斷的可能性。方法:收集胃腸胰神經(jīng)內(nèi)分泌腫瘤共36例。包括胃神經(jīng)內(nèi)分泌腫瘤(NEN)10例,腸道NEN10例(9例直腸,1例小腸),胰腺NEN16例。按照病理分級(jí)包括G1級(jí)14例,G2級(jí)10例,G3級(jí)12例。將每1例石蠟包埋組織留取3張切片,分別進(jìn)行HE染色重新確認(rèn)NEN診斷、SCGN和Cg A的免疫組織化學(xué)染色。用SPSS統(tǒng)計(jì)學(xué)軟件比較SCGN與Cg A的陽(yáng)性表達(dá)率及診斷胃腸胰神經(jīng)內(nèi)分泌腫瘤的敏感性,分析在不同的發(fā)病部位、腫瘤的不同分級(jí)中的表達(dá)情況以及與腫瘤的各項(xiàng)臨床特征的關(guān)系。結(jié)果:(1)36例GEP-NEN患者的石蠟包埋組織中SCGN陽(yáng)性表達(dá)率為88.9%(32/36),其中15例弱陽(yáng)性(+),14例陽(yáng)性(++),3例強(qiáng)陽(yáng)性(+++)。Cg A陽(yáng)性表達(dá)率為66.7%(24/36),其中5例弱陽(yáng)性(+),13例陽(yáng)性(++),6例強(qiáng)陽(yáng)性(+++)。SCGN的陽(yáng)性表達(dá)率較Cg A高(P0.05)。SCGN檢測(cè)GEP-NEN的敏感性(88.9%)高于Cg A的敏感性(66.7%)(P0.05)。(2)在胃和胰腺NEN中,SCGN與Cg A的表達(dá)差異無統(tǒng)計(jì)學(xué)意義(P0.05),在腸道NEN中SCGN的表達(dá)明顯比Cg A高(P0.05)。SCGN的表達(dá)在胃、腸道、胰腺不同部位之間比較無統(tǒng)計(jì)學(xué)差異(P0.05)。而Cg A在不同部位中的表達(dá)有顯著性差異(P0.05),Cg A在腸道NEN中均不表達(dá),組間兩兩比較,Cg A在腸NEN中的表達(dá)與胃或胰腺NEN組織中表達(dá)差異有意義(P0.017),在胃NEN與胰腺NEN中的差異無意義(P0.017)。(3)在GEP-NEN的3個(gè)病理分級(jí)中,SCGN與Cg A的表達(dá)差異無統(tǒng)計(jì)學(xué)意義(P0.05)。SCGN在G1級(jí)、G2級(jí)、G3級(jí)的腫瘤組織中的表達(dá)差異具有統(tǒng)計(jì)學(xué)意義(P0.05),組間兩兩比較,G1級(jí)與G2級(jí)、G2級(jí)與G3級(jí)腫瘤組織中SCGN的表達(dá)差異無統(tǒng)計(jì)學(xué)意義(P0.017),而SCGN在G3級(jí)腫瘤組織中的表達(dá)較G1級(jí)降低,差異有統(tǒng)計(jì)學(xué)意義(P0.017)。Cg A在GEP-NEN的不同的病理分級(jí)中表達(dá)無明顯統(tǒng)計(jì)學(xué)差異(P0.05)。(4)SCGN在不同的性別、年齡以及是否伴有神經(jīng)侵犯或脈管癌栓的腫瘤中的表達(dá)均無明顯統(tǒng)計(jì)學(xué)差異(P0.05),在最大徑2cm或2cm以上以及伴有淋巴轉(zhuǎn)移的腫瘤中SCGN的表達(dá)水平降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。Cg A在GEP-NEN的不同的臨床特征中均無顯著性差異(P0.05)。結(jié)論:在GEP-NEN中SCGN的陽(yáng)性表達(dá)率較Cg A陽(yáng)性表達(dá)率高;SCGN在胃、腸道、胰腺的NEN中均表達(dá)良好,與Cg A聯(lián)合有助于提高檢出率;SCGN在G3級(jí)GEP-NEN中的表達(dá)水平較G1級(jí)明顯降低,Cg A則無明顯差異;SCGN在直徑2cm或2cm以上、伴有淋巴轉(zhuǎn)移的GEP-NEN中表達(dá)水平下降;SCGN可作為神經(jīng)內(nèi)分泌腫瘤標(biāo)志物應(yīng)用于臨床診斷,且具有用于早期診斷及預(yù)后判斷的潛質(zhì)。
[Abstract]:Objective: to detect the expression of secretin and chromaffin A(Cg A in paraffin-embedded tissues of gastrointestinal and pancreatic neuroendocrine tumors (GEP-NEN). To explore the clinical significance of SCGN in GEP-NEN and the possibility of early diagnosis as neuroendocrine tumor markers. Methods: 36 cases of gastrointestinal and pancreatic neuroendocrine tumors were collected. There were 10 cases of gastric neuroendocrine neoplasms, 9 cases of intestinal NEN10, 1 case of small intestine and 1 case of pancreatic NEN16. According to the pathological grading, 14 cases of G 1 grade and 10 cases of G 2 grade were classified as G 3 grade 12 cases. Three sections were taken from each paraffin embedded tissue and the immunohistochemical staining of SCGN and CG A was reconfirmed by HE staining. The positive expression rate of SCGN and CG A and the sensitivity of diagnosis of gastrointestinal and pancreatic neuroendocrine tumors were compared by SPSS software. Results the positive expression rate of SCGN in paraffin-embedded tissues of 36 patients with GEP-NEN was 88.9 / 36, of which 15 were weak (14 / 36). There was no significant difference in the expression of SCGN between gastric and pancreatic NEN (P 0.05U. SCGN was significantly higher than that of CG A in detecting GEP-NEN (88. 9%) than that of CG A (66. 7%). The expression of SCGN in intestinal NEN was significantly higher than that of CG A (P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05), but the expression of SCGN in intestinal NEN was significantly higher than that in intestinal NEN (P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05, P 0. 05). The expression of CGA, P0.05, SCGN was found in the stomach. There was no significant difference between different parts of intestine and pancreas (P 0.05). However, there was a significant difference in the expression of CG A in different parts of the intestine. No significant difference was found in the expression of CPG A in intestinal NEN. Comparison between two groups in the expression of CGA in intestinal NEN and gastric or pancreatic NEN tissues, there was no significant difference in the expression of CGA between gastric NEN and pancreatic NEN (P0.017. 3) in three pathological grades of GEP-NEN, there was no significant difference in the expression of CGN and CG A in the three pathological grades of GEP-NEN. There was a significant difference in the expression of SCGN between G 1 group and G 2 grade G 2 and G 3 grade tumor tissues. There was no significant difference in the expression of SCGN between G 1 grade and G 2 grade G 2 and G 3 grade tumor tissues, while the expression of SCGN in G 3 grade tumor tissues had no significant difference (P 0.017%). The expression level in the tissue was lower than that in the G1 level. There was no significant difference in the expression of P0.017A in different pathological grades of GEP-NEN. There was no significant difference in age and the expression of SCGN in tumors with or without nerve invasion or vascular tumor thrombus. The expression level of SCGN was decreased in tumors with maximum diameter 2cm or 2cm or with lymphatic metastasis. There was no significant difference in the clinical characteristics of GEP-NEN. Conclusion: the positive expression rate of SCGN in GEP-NEN is higher than that in CG A. The positive expression of SCGN in gastric, intestinal and pancreatic NEN is good. In combination with CG A, the expression of SCGN in G3 GEP-NEN was significantly lower than that in G1 grade. There was no significant difference in SCGN over diameter 2cm or 2cm. GEP-NEN with lymphatic metastasis can be used as a neuroendocrine tumor marker for clinical diagnosis and has the potential for early diagnosis and prognostic judgment.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735

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