本文選題：甲狀腺乳頭狀癌 + NIS蛋白　； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:通過(guò)研究山東省青島地區(qū)PTC患者的BRAF突變蛋白(鼠類肉瘤濾過(guò)性毒菌致癌同源體B1)、鈉碘轉(zhuǎn)運(yùn)體(sodium/iodide symporter,NIS)蛋白的表達(dá)情況,探討了NIS、BRAF突變蛋白之間的關(guān)系,及其和PTC腫瘤參數(shù)之間的關(guān)系,同時(shí)分析了~(131)I治療效果與BRAF突變蛋白、NIS蛋白及病理參數(shù)的關(guān)系,為PTC的診斷、治療、預(yù)后提供臨床指導(dǎo)意義。方法:應(yīng)用NIS、BRAF單克隆抗體及免疫組化法檢測(cè)青島大學(xué)附屬醫(yī)院(黃島院區(qū))在2015年1月至2015年12月期間,術(shù)后的留檔蠟塊60例,包括PTC 40例、結(jié)甲20例,分別行BRAF突變蛋白及NIS蛋白的免疫組化。(1)分析PTC及結(jié)甲患者中NIS、BRAF突變蛋白的表達(dá);(2)分析40例PTC中NIS、BRAF突變蛋白表達(dá)情況與腫瘤參數(shù)、~(131)I治療效果的相關(guān)性。(3)將PTC按照癌旁組織不同分為結(jié)甲組、正常組,進(jìn)一步分析兩組之間NIS、BRAF突變蛋白、~(131)I治療效果及病理參數(shù)等的差異。結(jié)果:1.在40例PTC中,BRAF突變蛋白陽(yáng)性表達(dá)33例(82.5%),在20例結(jié)甲組織中,無(wú)陽(yáng)性表達(dá),經(jīng)卡方檢驗(yàn),差異有顯著意義(p0.05);2.在40例PTC患者中NIS蛋白表達(dá)的有33例(82.5%),20例結(jié)甲組織中有18例為陽(yáng)性(90%),經(jīng)卡方檢驗(yàn)差異無(wú)意義(P0.05);3.在33例NIS蛋白表達(dá)的PTC組織中,2例(6.1%)在胞膜上,31例(93.9%)在胞質(zhì)中,18例NIS蛋白表達(dá)的結(jié)甲組織中,17例在胞膜上表達(dá),1例在胞質(zhì)中表達(dá),經(jīng)Fisher檢驗(yàn),差異有明顯統(tǒng)計(jì)學(xué)意義(p0.001);4.在40例PTC組織中,經(jīng)spearman相關(guān)性分析,認(rèn)為BRAF、NIS具有正相關(guān)關(guān)系(r=0.596,p0.01);5.在40例PTC組織中,經(jīng)卡方檢驗(yàn),性別間BRAF突變蛋白表達(dá)差異有意義(p=0.089);6.在40例PTC組織中,經(jīng)spearman相關(guān)分析,認(rèn)為~(131)I治療效果與BRAF突變蛋白表達(dá)呈負(fù)相關(guān)(r=-0.225,p=0.028);7.PTC分組中,經(jīng)t檢驗(yàn),顯示正常組與結(jié)甲組中~(131)I治療效果及病灶數(shù)的差異有顯著意義(P=0.025,p0.001)。結(jié)論:1.山東省青島地區(qū)散發(fā)PTC患者中BRAF突變蛋白檢測(cè)率較高,結(jié)甲患者無(wú)陽(yáng)性表達(dá)。應(yīng)用免疫組化法去檢測(cè)BRAF突變蛋白的表達(dá)情況,可以為甲狀腺結(jié)節(jié)性質(zhì)的判斷提供臨床參考價(jià)值。2.NIS轉(zhuǎn)運(yùn)蛋白在PTC及結(jié)甲患者中,其量及強(qiáng)度無(wú)明顯的差別。碘治療的效果可能與NIS蛋白定位有關(guān),錯(cuò)誤定位可能引起治療抵抗或失敗。3.碘治療效果可能受腫瘤旁組織影響,腫瘤旁為正常組織比結(jié)甲患者效果好。4.在常規(guī)檢查基礎(chǔ)上聯(lián)合檢測(cè)NIS、BRAF突變蛋白的表達(dá),可為PTC患者診斷、~(131)I治療及疾病的預(yù)后提供更高的臨床參考價(jià)值。
[Abstract]:Objective: to study the expression of BRAF mutant protein (B1T, sodium iodide symporter) in PTC patients with sarcoma leucosarcoma, and to explore the relationship between NIS-BRAF mutation protein. The relationship between PTC and tumor parameters was also analyzed, and the relationship between the therapeutic effect and the BRAF mutant protein and pathological parameters were analyzed, which provided clinical guidance for the diagnosis, treatment and prognosis of PTC. Methods: NIS-BRAF monoclonal antibody and immunohistochemical method were used to detect 60 cases of wax blocks, including 40 cases of PTC and 20 cases of armour formation, from January 2015 to December 2015 in the affiliated Hospital of Qingdao University (Huangdao Hospital). Immunohistochemical analysis of BRAF mutant protein and NIS protein was performed in 40 cases of PTC. The expression of NIS-BRAF mutant protein was analyzed by immunohistochemistry. The expression of NIS-BRAF mutant protein was analyzed in 40 cases of PTC. The relationship between the expression of NIS-BRAF mutant protein and the therapeutic effect of tumor parameter, Angii 131I, was analyzed respectively. 3) the relationship between the expression of NIS-BRAF mutant protein and the therapeutic effect of NIS-BRAF in 40 cases of PTC was analyzed. Paracancerous tissues were divided into knot A group. In the normal group, the difference of the therapeutic effect and pathological parameters of NIS-BRAF mutant protein (NIS-BRAF) was further analyzed between the two groups. The result is 1: 1. In 40 cases of PTC, 33 cases had positive expression of BRAF mutant protein, 33 cases had positive expression of BRAF protein, but in 20 cases of thyroid tissue, there was no positive expression. The difference was significant by chi-square test. Of the 40 cases of PTC, there were 33 cases with positive expression of NIS protein, 18 of 20 cases of thyroid tissue were positive, there was no significant difference between them by chi-square test (P 0.05). In 33 cases of PTC with NIS protein expression, 2 cases (6. 1) were expressed on the membrane of 31 cases (93. 9%) in the cytoplasm of 18 cases of NIS protein expression, 17 cases were expressed on the membrane of 1 case in the cytoplasm. By Fisher test, the difference was statistically significant (P 0. 001 4). In 40 cases of PTC, spearman correlation analysis showed that BRAFN had a positive correlation with 0.596nis, p0.01a. In 40 cases of PTC, it was found by chi-square test that there was significant difference in the expression of BRAF mutant protein between sexes. In 40 cases of PTC, the results of spearman correlation analysis showed that there was a negative correlation between the therapeutic effect and the expression of BRAF mutant protein. The t test showed that there was a significant difference in the therapeutic effect and the number of lesions between the normal group and the nodular group. Conclusion 1. The detection rate of BRAF mutation protein was higher in sporadic PTC patients in Qingdao, Shandong province. Immunohistochemical method was used to detect the expression of BRAF mutant protein. 2. There was no significant difference in the quantity and intensity of NIS transporter in patients with PTC and thyroid nodule. The effect of iodine therapy may be related to the localization of NIS protein, and false localization may cause resistance or failure of treatment. The effect of iodine therapy may be affected by paraneoplastic tissue. The combined detection of NIS-BRAF mutant protein on the basis of routine examination can provide a higher clinical reference value for the diagnosis of PTC patients and the prognosis of the disease.
【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)】：R736.1

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本文編號(hào)：1850717