本文選題：胸腺瘤 + 胸腺癌��； 參考：《河北醫(yī)科大學》2016年碩士論文

【摘要】：背景:胸腺上皮腫瘤發(fā)病率低,病程發(fā)展緩慢,病理類型復雜,分類方法繁多,既有顯微鏡下復雜的組織結構,病理與預后又不統(tǒng)一,而且臨床上有關的前瞻性隨機對照的實驗研究很少,導致臨床醫(yī)師對胸腺瘤認識相對不足,對其合理的病理分類及治療模式存在爭議。目的:研究c-kit、PTEN在胸腺上皮腫瘤中的表達情況,探討兩者與胸腺上皮腫瘤的病理類型、臨床分期及是否合并重癥肌無力(MG)的關系。方法:收集經手術切除且病理證實為胸腺增生、胸腺瘤及胸腺癌的病例,所有患者均未經術前化療或放療。記錄每個胸腺上皮腫瘤患者的病理分型、臨床分期及是否合并重癥肌無力等情況。應用免疫組織化學方法(S-P法)檢測14例胸腺增生、60例胸腺瘤、12例胸腺癌的c-kit、PTEN表達情況,所得結果應用SPSS19.0進行統(tǒng)計分析。結果:1 c-kit在胸腺增生、胸腺瘤、胸腺癌三組中的陽性表達率依次為7.1%,13.3%,66.7%,呈逐漸增加趨勢,且之間有顯著性差異(P0.05);c-kit在非侵襲性胸腺瘤患者(A型+AB型)中陽性表達率為9.4%,這低于侵襲性胸腺瘤患者(B1型+B2型+B3型)中的陽性表達率17.9%,差異無統(tǒng)計學意義(P=0.335);c-kit在Masaoka分期中I期、II期、III期、IV期陽性表達率依次為12.5%、13.3%、15.4%、12.5%,之間無顯著性差異(P=0.998);c-kit在合并MG的胸腺瘤中的陽性表達率及未合并MG的胸腺瘤中的陽性表達率依次為13.5%,13.0%,二者之間無顯著性差異(P=0.985)。2 PTEN在胸腺增生、胸腺瘤、胸腺癌三組的陽性表達率依次為85.7%、55.0%、16.7%,呈逐步降低的趨勢,三者之間差異有統(tǒng)計學意義(P0.05);PTEN在非侵襲性胸腺瘤患者(A型+AB型)中的陽性表達率為71.9%,明顯高于侵襲性胸腺瘤患者(B1型+B2型+B3型)中的陽性表達率35.7%,兩者的差異有統(tǒng)計學意義(P0.05);PTEN在Masaoka分期中I期、II期、III期、IV期的陽性表達率分別為83.3%、53.3%、30.8%、12.5%,呈逐步降低的趨勢,四者之間存在顯著性差異(P0.05);PTEN在合并MG與未合并MG的胸腺瘤中的陽性表達率依次為54.1%、60.9%,兩者之間無顯著性差異(P=0.604)。結論:1 c-kit蛋白表達與胸腺病理分型存在正相關,與胸腺瘤的侵襲性關系不明顯,表明c-kit是一個鑒別胸腺瘤和胸腺癌的很好的分子標記。2 PTEN表達與胸腺病理類型及Masaoka分期均呈明顯負相關,說明PTEN不僅有利于幫助胸腺瘤、胸腺癌的診斷,而且可為胸腺瘤的侵襲性診斷提供依據。3 c-kit和PTEN在胸腺上皮腫瘤的發(fā)生、進展中起一定作用,檢測它們有助于綜合評估及指導治療。c-kit和PTEN在胸腺瘤中的表達與是否合并重癥肌無力無關。
[Abstract]:Background: the incidence of thymic epithelial tumors is low, the course of disease is slow, the pathological types are complex, the classification methods are various, there are complicated histological structures under microscope, and the pathology and prognosis are not unified. Moreover, there are few prospective randomized controlled clinical studies, which leads to the lack of understanding of thymoma, and the reasonable pathological classification and treatment mode of thymoma are controversial. Objective: to investigate the expression of c-kittene PTEN in thymic epithelial tumors and its relationship with the pathological types, clinical stages and myasthenia gravis (MG). Methods: all patients with thymic hyperplasia, thymoma and thymic carcinoma confirmed by surgery and pathology were not treated with chemotherapy or radiotherapy before operation. The pathological classification, clinical stage and myasthenia gravis were recorded for each thymic epithelial tumor. The expression of c-kitt PTEN in 14 cases of thymic hyperplasia and 12 cases of thymic carcinoma was detected by immunohistochemical method (S-P method). The results were statistically analyzed by SPSS19.0. Results the positive expression rate of c-kit in the three groups of thymic hyperplasia, thymoma and thymic carcinoma was 7.1 and 13.36.7respectively. The positive expression rate of c-kit in non-invasive thymoma patients was 9.4, which was lower than that in invasive thymoma patients with B _ 1 type B _ 2 B _ 3). There was no significant difference between them. The positive expression rate of c-kit in Masaoka stage I, stage II, stage III and stage IV was 12.5T, 13.3C and 15.4T, respectively. There was no significant difference between the two groups. There was no significant difference in the positive expression of c-kit in thymoma with MG, and the positive expression rate of c-kit in thymoma without MG was 13.5T and 13.0T, respectively. The positive expression rate of c-kit in thymoma with MG and without MG was 13.5T and 13.0T, respectively. There was no significant difference between the two groups in the thymus hyperplasia, and there was no significant difference between them. The positive expression rates of thymoma and thymic carcinoma were 85.7% and 55.0%, respectively. The positive expression rate of P0.05PTEN in non-invasive thymoma patients was 71.9, which was significantly higher than that in invasive thymoma patients with type B1 B2 B3). The positive expression rates of P0.05 / PTEN in Masaoka stage I / II / III / IV were 83.3 / 53.3and 30.8 / 12.5respectively, which showed a trend of gradual decrease. There was significant difference among the four groups. The positive expression rate of P0.05 and PTEN in thymoma with and without MG was 54.1 and 60.9, respectively. There was no significant difference between the two groups (P = 0.604). Conclusion there is a positive correlation between the expression of c-kit protein and the pathological type of thymus, but there is no significant relationship between the expression of c-kit protein and the invasiveness of thymoma. The results indicate that c-kit is a good molecular marker for differentiating thymoma from thymic carcinoma. The expression of 2. 2 PTEN is negatively correlated with the pathological type of thymus and Masaoka stage, which indicates that PTEN is not only helpful for the diagnosis of thymoma and thymic carcinoma, but also helpful to the diagnosis of thymoma. Moreover, it can provide evidence for invasive diagnosis of thymoma. 3. 3 c-kit and PTEN may play a role in the occurrence and progression of thymoma. Detecting the expression of. C-kit and PTEN in thymoma is helpful to evaluate and guide the treatment of thymoma. There is no correlation between the expression of c-kit and PTEN in thymoma.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R736.3

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