本文選題：結(jié)直腸癌 + 循環(huán)腫瘤細(xì)胞�。� 參考：《南方醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:本文利用多重RAN原位雜交方法,對結(jié)直腸癌患者外周血循環(huán)腫瘤細(xì)胞進(jìn)行分型及FAM172A檢測,分析其表達(dá)與患者腫瘤侵潤深度、淋巴結(jié)轉(zhuǎn)移、遠(yuǎn)處轉(zhuǎn)移、TNM分期等臨床特征參數(shù)之間的關(guān)系,研究不同類型循環(huán)腫瘤細(xì)胞的轉(zhuǎn)移潛能,探討循環(huán)腫瘤細(xì)胞分型與FAM172A在結(jié)直腸癌診療中的臨床價值。方法:1.采集2015年6月至2015年12月南方醫(yī)科大學(xué)珠江醫(yī)院普通外科45例結(jié)直腸癌患者外周血5ml,采集同期收治10例結(jié)直腸良性腫物患者外周血5ml。將紅細(xì)胞裂解過濾,通過直徑8 μm的納米膜系統(tǒng)富集循環(huán)腫瘤細(xì)胞,然后利用4組特異性核酸探針進(jìn)行多重RAN原位雜交,通過不同顏色熒光信號來鑒定循環(huán)腫瘤細(xì)胞的分型及FAM172A表達(dá)情況。2.統(tǒng)計學(xué)分析:本實驗數(shù)據(jù)采用Spss20.0軟件進(jìn)行統(tǒng)計學(xué)分析,其中CTCs、FAM172A與患者臨床特征參數(shù)的關(guān)系采用x2檢驗,計量資料的組間比較采用非參數(shù)檢驗,當(dāng)P0.05表示為差異有統(tǒng)計學(xué)意義。結(jié)果:1.運用納米膜技術(shù)與多重RAN原位分析技術(shù)的檢測方法,對循環(huán)腫瘤細(xì)胞分為eCTCs(上皮型)、bCTCs(混合型)、mCTCs(間質(zhì)型);45例結(jié)直腸癌患者檢測CTCs陽性率為62.2%,mCTCs檢測陽性率為57.8%,而對照組患者未檢測CTCs存在,兩組CTCs陽性率比較差異有統(tǒng)計學(xué)意義(P0.05)。2.循環(huán)腫瘤細(xì)胞陽性率與結(jié)直腸癌大多數(shù)臨床特征無明顯相關(guān)關(guān)系(P0.05),但間質(zhì)型循環(huán)腫瘤細(xì)胞與結(jié)直腸癌發(fā)生脈管侵潤及遠(yuǎn)處轉(zhuǎn)移呈顯著相關(guān)(P0.05)。3.FAM172A在CTCs總體檢出率為60.7%,其中上皮型CTCs為56.3%,混合型CTCs 為 58.6%,而間質(zhì)型 CTCs 為 68.8%。4.在循環(huán)腫瘤細(xì)胞陽性的結(jié)直腸癌患者中,FAM172A表達(dá)率與腫瘤侵潤深度及Ki-67水平呈顯著相關(guān)(P0.05),在間質(zhì)型循環(huán)腫瘤細(xì)胞陽性的結(jié)直腸癌患者中,FAM172A表達(dá)率與腫瘤侵潤深度及脈管侵潤呈顯著相關(guān)(P0.05)。5.在Ⅱ期結(jié)直腸癌患者中,高危組患者中mCTCs陽性率及FAM172A表達(dá)陽性率均明顯高于低危組患者的mCTCs陽性率及FAM172A表達(dá)陽性率,但兩組比較差異無統(tǒng)計學(xué)意義(P0.05)。需增加樣本量檢測對此結(jié)果加以驗證。結(jié)論:1.基于納米膜技術(shù)與多重RAN原位分析技術(shù)的檢測方法,可以有效對結(jié)直腸癌患者外周血循環(huán)腫瘤細(xì)胞進(jìn)行分型,包括上皮型、混合型及間質(zhì)型,并且在不同類型的循環(huán)腫瘤細(xì)胞中FAM172A表達(dá)率不同,其中在間質(zhì)型循環(huán)腫瘤細(xì)胞最高。2.間質(zhì)型循環(huán)腫瘤細(xì)胞可能與結(jié)直腸癌血行轉(zhuǎn)移相關(guān),可能參與腫瘤進(jìn)展過程。3.FAM172A可能參與結(jié)直腸癌的侵襲與轉(zhuǎn)移過程,與結(jié)直腸癌進(jìn)展相關(guān)。4.聯(lián)合檢測循環(huán)腫瘤細(xì)胞分型及FAM172A,有望成為預(yù)測結(jié)直腸癌患者預(yù)后的潛在有效生物學(xué)指標(biāo)。
[Abstract]:Objective: to study the expression of circulating tumor cells in peripheral blood of patients with colorectal cancer and to analyze their expression with tumor invasion depth and lymph node metastasis by in situ hybridization with multiple RAN. To study the metastatic potential of different circulating tumor cells and to explore the clinical value of circulating tumor cell classification and FAM172A in the diagnosis and treatment of colorectal cancer. Method 1: 1. From June 2015 to December 2015, the peripheral blood of 45 patients with colorectal cancer in Zhujiang Hospital of Southern Medical University and 5 ml of peripheral blood of 10 patients with benign colorectal tumor were collected. The circulating tumor cells were enriched with RBC cleavage and filtration through a nanofilm system with diameter of 8 渭 m, and then multiplex RAN in situ hybridization was performed using four groups of specific nucleic acid probes. The cell types and FAM172A expression of circulating tumor cells were identified by different color fluorescence signals. Statistical analysis: the data of this experiment were analyzed by Spss20.0 software. The relationship between CTCsfam 172A and the clinical characteristic parameters of patients was tested by x2 test. The non-parametric test was used in the comparison of measurement data. The difference was statistically significant when P0.05 was expressed. The result is 1: 1. The detection method of nanofilm and multiplex RAN in situ analysis was used. The positive rate of CTCs was 62.2% in 45 patients with colorectal cancer, while no CTCs was detected in the control group. There was a significant difference between the two groups in the positive rate of CTCs. There was no significant correlation between the positive rate of circulating tumor cells and most clinical features of colorectal cancer. However, there was a significant correlation between circulating tumor cells of interstitial type and vascular invasion and distant metastasis of colorectal cancer. 3. FAM172A was detected in 60.7 patients with CTCs. The epithelial type of CTCs was 56.3%, the mixed type of CTCs was 58.6%, and the interstitial type of CTCs was 68.8%. 4. The expression rate of FAM172A was significantly correlated with the depth of tumor invasion and the level of Ki-67 in colorectal cancer patients with positive circulating tumor cells. The expression rate of FAM172A was significantly correlated with the depth of tumor invasion and the depth of tumor invasion in patients with colorectal cancer with positive interstitial circulating tumor cells. There was a significant correlation between vascular invasion and embellishment (P0.05. 5). The positive rate of mCTCs and FAM172A expression in high risk group was significantly higher than that in low risk group, but there was no significant difference between the two groups. This result needs to be verified by increasing sample size. Conclusion 1. Based on the technique of nanomembrane and multiplex RAN in situ analysis, it can be used to type circulating tumor cells in peripheral blood of colorectal cancer patients, including epithelial type, mixed type and interstitial type. The expression rate of FAM172A was different in different types of circulating tumor cells, and the highest expression rate of FAM172A was found in stromal circulating tumor cells. Interstitial circulating tumor cells may be associated with blood metastasis of colorectal cancer. 3. FAM172A may be involved in the invasion and metastasis of colorectal cancer, and may be related to the progression of colorectal cancer. Combined detection of circulating tumor cell types and FAM172A is expected to be a potential biological marker for predicting the prognosis of colorectal cancer patients.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.34

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