本文選題：葉酸受體α + CA125�。� 參考：《南方醫(yī)科大學(xué)》2017年碩士論文

【摘要】：研究背景子宮內(nèi)膜癌是發(fā)生在子宮內(nèi)膜的一類上皮性惡性腫瘤,其發(fā)病率在一些歐洲發(fā)達(dá)國家已居于女性生殖道惡性腫瘤首位。近年發(fā)病率在世界范圍內(nèi)呈上升且年輕化趨勢,其病因及發(fā)病機制未完全明確,治療仍無突破性進(jìn)展,術(shù)后生存率仍有待提高。目前,子宮內(nèi)膜癌的診斷主要依靠癥狀、超聲、診刮術(shù)、腫瘤標(biāo)志物等輔助檢查。診斷性刮宮為最常見而有價值的診斷方法。為提高子宮內(nèi)膜癌患者的生存期及生活質(zhì)量,早發(fā)現(xiàn)、早診斷并盡早干預(yù)是關(guān)鍵。近期,有報道指出,葉酸受體α(FRA)在大部分子宮內(nèi)膜癌組織中呈高表達(dá),有望成為新的腫瘤標(biāo)志物。FRA是一種糖基磷脂酰肌醇偶聯(lián)蛋白,在正常組織中表達(dá)極低,但在上皮性惡性腫瘤細(xì)胞表達(dá)明顯上升。正因為這一表達(dá)差異及特異性,使之有望成為新型生物標(biāo)志物,協(xié)助腫瘤的診斷、監(jiān)測及預(yù)后判斷。本研究團隊前期研究發(fā)現(xiàn),子宮內(nèi)膜癌患者血清FRA表達(dá)顯著升高,那么,FRA在子宮內(nèi)膜癌組織中的表達(dá)及意義如何?CA125是最常見的婦科腫瘤標(biāo)志物,現(xiàn)已被廣泛用于泌尿生殖系統(tǒng)、消化系統(tǒng)等腫瘤的診斷和追蹤。目前,對于CA125在子宮內(nèi)膜癌中的表達(dá)研究多局限于血清學(xué)方面,然而大多數(shù)學(xué)者認(rèn)為血清CA125水平并不能準(zhǔn)確反應(yīng)腫瘤的進(jìn)展程度。那么CA125在內(nèi)膜病變組織中表達(dá)如何?其與FRA是否存在相關(guān)性?對臨床診斷及預(yù)后判斷是否存在意義?目的通過檢測不同內(nèi)膜病變組織中FRA、CA125的表達(dá)差異及與臨床病理特征的關(guān)系,探討FRA在子宮內(nèi)膜癌變過程的臨床意義及可能的機制,分析FRA與CA125的相關(guān)性,探討兩者對臨床診斷及預(yù)后判斷的意義。方法收集子宮內(nèi)膜腺癌標(biāo)本60例,隨機選取子宮內(nèi)膜增生癥46例及正常子宮內(nèi)膜10例,采用免疫組化法檢測組織中FRA、CA125的表達(dá)。陽性染色為細(xì)胞膜及細(xì)胞質(zhì)中呈現(xiàn)棕黃色或棕褐色顆粒,與陰性表達(dá)的比較。結(jié)果1、FRA在正常子宮內(nèi)膜、子宮內(nèi)膜增生癥及子宮內(nèi)膜癌組織中均可見表達(dá),陽性率分別為10.0%、45.7%、93.3%,且在內(nèi)膜癌中呈高表達(dá)(65.0%),較增生癥組和正常組升高(P0.05)。2、復(fù)雜型子宮內(nèi)膜增生組織中FRA的陽性率較單純型升高,伴不典型增生較其他類型表達(dá)率升高(P0.05);內(nèi)膜癌組中,FRA的表達(dá)與年齡、FIGO手術(shù)病理分期、分化程度有關(guān)(P0.05)。3、CA125在正常子宮內(nèi)膜組織中以低表達(dá)為主,在增生癥及內(nèi)膜癌組織中則以高表達(dá)為主。FRA及CA125在子宮內(nèi)膜癌變過程中呈弱正相關(guān)關(guān)系(r=0.204,P=0.028)。結(jié)論1、子宮內(nèi)膜從正常增殖到增生、出現(xiàn)不典型增生繼而癌變,組織中FRA的表達(dá)呈逐步上調(diào)趨勢,提示FRA可能參與到子宮內(nèi)膜病變甚至癌癥發(fā)生當(dāng)中;FRA作為一種新型生物標(biāo)志物,為子宮內(nèi)膜癌的靶向診斷提供理論基礎(chǔ)。2、子宮內(nèi)膜癌中FRA的表達(dá)較非癌變組織明顯增高,且與腫瘤的分化、分期相關(guān),提示FRA有望成為子宮內(nèi)膜癌新的治療靶點。3、FRA與CA125在子宮內(nèi)膜癌變過程中均呈上調(diào)趨勢,兩者聯(lián)合用于診斷子宮內(nèi)膜癌的效果優(yōu)于單一指標(biāo)。
[Abstract]:Background endometrial carcinoma is a kind of epithelial malignant tumor occurring in the endometrium. Its incidence is in the first place in some European developed countries. In recent years, the incidence of cancer is rising and young in the world. Its etiology and pathogenesis are not completely clear, and the treatment is still without breakthrough. The survival rate remains to be improved. At present, the diagnosis of endometrial cancer is mainly dependent on symptoms, ultrasound, curettage, and tumor markers. Diagnostic curettage is the most common and valuable diagnostic method. To improve the survival and quality of life of patients with endometrial cancer, early detection, early diagnosis and early intervention are the key. The expression of folate receptor alpha (FRA) is highly expressed in most endometrium cancer tissues and is expected to become a new tumor marker,.FRA, a glycosylphosphatidyl inositol coupling protein, which is very low in normal tissues, but in epithelial malignant tumor cells. Biomarkers to assist in the diagnosis, monitoring and prognosis of cancer. Earlier studies of this team found that the expression of FRA in endometrial cancer patients increased significantly. Then, how is the expression and significance of FRA in endometrial carcinoma? CA125 is the most common gynecologic tumor marker and is now widely used in the genitourinary system and in the digestive system. Diagnosis and tracking of tumors. Currently, the expression of CA125 in endometrial cancer is mostly confined to serology. However, most scholars believe that serum CA125 levels do not accurately reflect the progression of cancer. Then how does CA125 express in endometrial tissue? Is there a correlation with FRA? Clinical diagnosis and prediagnosis To determine the significance of post judgment? Objective to explore the clinical significance and possible mechanism of FRA in the process of endometrial carcinogenesis by detecting the difference in expression of FRA and CA125 and its relationship with clinicopathological features in different endometrium tissues, and analyzing the correlation between FRA and CA125, and exploring the significance of the two methods for the diagnosis and prognosis of the endometrium. Method collection of methods. 60 cases of endometrial adenocarcinoma were selected, 46 cases of endometrial hyperplasia and 10 cases of normal endometrium were randomly selected. The expression of FRA and CA125 in tissue was detected by immunohistochemistry. The positive staining showed that brown or brown brown granules in the cell membrane and cytoplasm were compared with negative expression. The results were 1, FRA in normal endometrium and endometrial hyperplasia. The positive rates of the endometrial carcinoma were 10%, 45.7%, 93.3%, respectively, and high expression in endometrial carcinoma (65%), higher than that of the hyperplasia and normal groups (P0.05).2. The positive rate of FRA in the complex endometrium hyperplasia was higher than that of the simple type, with the increase of other types of atypical hyperplasia (P0.05), and the endometrial carcinoma group. The expression of FRA was associated with age, pathological staging of FIGO, degree of differentiation (P0.05).3, CA125 was mainly low in normal endometrium, and high expression of.FRA and CA125 in hyperplasia and endometrial carcinoma tissues were weakly positive (r=0.204, P=0.028) in the process of endometrial carcinogenesis (r=0.204, P=0.028). Conclusion 1, endometrium increased from normal. The expression of FRA in tissue is gradually up-regulated, suggesting that FRA may be involved in endometrial lesions and even cancer. As a new biomarker, FRA provides a theoretical basis for the target diagnosis of endometrial cancer, and the expression of FRA in endometrial carcinoma is more than that of non cancerous tissue. Xian Zenggao, which is associated with tumor differentiation and staging, suggests that FRA is expected to be a new therapeutic target for endometrial cancer,.3. Both FRA and CA125 are up-regulated in the process of endometrial carcinogenesis, and the combination of both of them in the diagnosis of endometrial cancer is superior to that of a single index.
【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】：R737.33

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