發(fā)布時(shí)間：2018-06-05 07:53

  本文選題：乳腺癌 + 骨轉(zhuǎn)移　； 參考：《川北醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:探討B(tài)cl-2、Caspase-3在乳腺癌骨轉(zhuǎn)移患者組織中的表達(dá)及意義,進(jìn)一步分析兩者與乳腺癌骨轉(zhuǎn)移臨床病理學(xué)參數(shù)間的關(guān)系,探尋乳腺癌骨轉(zhuǎn)移的風(fēng)險(xiǎn)因素。方法:分別納入乳腺癌骨轉(zhuǎn)移患者40例、乳腺癌無骨轉(zhuǎn)移患者30例、乳腺良性增生患者30例,對(duì)所有病例行免疫組織化學(xué)檢測Bcl-2、Caspase-3的表達(dá)情況,分析乳腺癌骨轉(zhuǎn)移患者的全身骨顯像特點(diǎn),乳腺癌骨轉(zhuǎn)移與Bcl-2、Caspase-3表達(dá)之間的相關(guān)性以及兩者與乳腺癌骨轉(zhuǎn)移臨床病理學(xué)參數(shù)之間的關(guān)系。結(jié)果:1.乳腺癌骨轉(zhuǎn)移至脊柱占60%,高于胸部(57.5%)、骨盆(42.5%)、四肢(20%)和顱骨(7.5%),差異顯著(χ2=36.380,P0.01)。2.Bcl-2在70例乳腺癌組織中的陽性表達(dá)率為71.4%,明顯高于乳腺良性增生組(46.7%),具有統(tǒng)計(jì)學(xué)意義(χ2=5.589,P0.05);Bcl-2在乳腺癌骨轉(zhuǎn)移組中的陽性表達(dá)率為72.5%,稍高于乳腺癌無骨轉(zhuǎn)移組(70%),但兩者差異無統(tǒng)計(jì)學(xué)意義(χ2=0.053,P0.05)。3.Caspase-3在70例乳腺癌組織中的陽性表達(dá)率為82.6%,稍高于乳腺良性增生組(80%),但兩者差異不具有統(tǒng)計(jì)學(xué)意義(χ2=0.116,P0.05);Caspase-3在乳腺癌骨轉(zhuǎn)移組中的陽性表達(dá)率為92.5%,明顯高于乳腺癌無骨轉(zhuǎn)移組(70%),兩者差異具有統(tǒng)計(jì)學(xué)意義(χ2=6.11,P0.05)。4.乳腺癌骨轉(zhuǎn)移患者中Bcl-2的陽性表達(dá)率與ER、PR的表達(dá)情況有關(guān),具有統(tǒng)計(jì)學(xué)差異(χ21=7.595,P10.01;χ22=5.021,P20.05),且呈正相關(guān)(r1=0.498,P10.01;r2=0.411,P20.01),而與其他臨床病理學(xué)參數(shù)(年齡、腫瘤直徑、腋淋巴結(jié)轉(zhuǎn)移、組織學(xué)分級(jí)、HER-2及Ki-67表達(dá))均無關(guān)(P0.05)。5.乳腺癌骨轉(zhuǎn)移患者中Caspase-3的陽性表達(dá)率與各臨床病理學(xué)參數(shù)(年齡、腫瘤直徑、腋淋巴結(jié)轉(zhuǎn)移、組織學(xué)分級(jí)、ER、PR、HER-2及Ki-67表達(dá))均無關(guān)(P0.05)。6.Bcl-2、Caspase-3兩者在乳腺癌組織中的表達(dá)不具有相關(guān)性(P0.05)。7.乳腺癌骨轉(zhuǎn)移與Caspase-3陽性表達(dá)有關(guān),Caspase-3陽性組骨轉(zhuǎn)移率(62.7%)明顯高于陰性組(27.2%),兩者差異具有統(tǒng)計(jì)學(xué)意義(χ2=4.755,P0.05);乳腺癌骨轉(zhuǎn)移與腋淋巴結(jié)轉(zhuǎn)移有關(guān),乳腺癌患者腋淋巴結(jié)轉(zhuǎn)移組骨轉(zhuǎn)移率(69.7%)高于無腋淋巴結(jié)轉(zhuǎn)移組(45.9%),差異具有統(tǒng)計(jì)學(xué)意義(χ2=4.018,P0.05);乳腺癌骨轉(zhuǎn)移與其他臨床病理學(xué)因素(年齡、腫瘤直徑、組織學(xué)分級(jí)、Bcl-2、ER、PR、HER-2及Ki-67表達(dá))無關(guān)(P0.05)。結(jié)論:1.Bcl-2、Caspase-3在乳腺癌組織中都是高表達(dá),二者間不具有相關(guān)性,提示其介導(dǎo)的細(xì)胞凋亡途徑在乳腺癌的發(fā)生發(fā)展過程中發(fā)揮著重要作用,可以為乳腺診斷與治療提供新的靶點(diǎn)選擇;2.Bcl-2表達(dá)在乳腺癌有無骨轉(zhuǎn)移組間沒有差異,但與患者ER、PR呈正相關(guān),提示Bcl-2的表達(dá)情況可能作為乳腺癌骨轉(zhuǎn)移患者是否選擇內(nèi)分泌治療的依據(jù)之一;3.Caspase-3表達(dá)在乳腺癌有無骨轉(zhuǎn)移組間差異明顯,提示Caspase-3高表達(dá)與乳腺癌骨轉(zhuǎn)移有關(guān),與腋淋巴結(jié)轉(zhuǎn)移一樣,可能是乳腺癌發(fā)生骨轉(zhuǎn)移的風(fēng)險(xiǎn)因素。
[Abstract]:Objective: to investigate the expression and significance of Bcl-2Caspase-3 in breast cancer patients with bone metastasis, to further analyze the relationship between Bcl-2Caspase-3 and clinicopathological parameters of breast cancer bone metastasis, and to explore the risk factors of breast cancer bone metastasis. Methods: 40 cases of breast cancer with bone metastasis, 30 cases of breast cancer without bone metastasis and 30 cases of benign hyperplasia of mammary gland were included. The expression of Bcl-2Caspase-3 was detected by immunohistochemistry in all cases. To analyze the characteristics of bone imaging in patients with bone metastasis of breast cancer, the correlation between bone metastasis of breast cancer and the expression of Bcl-2Caspase-3, and the relationship between them and clinicopathological parameters of bone metastasis of breast cancer. The result is 1: 1. The breast cancer bone metastasis to the spinal column accounted for 60 cases, which was higher than that of the thoracic cavity 57.5%, the pelvic cavity 42.5 and the extremities 20%. There was a significant difference between the breast cancer bone and the cranial bone. The positive expression rate of Bcl-2 in 70 cases of breast cancer was 71.4, which was significantly higher than that in the benign hyperplasia group (蠂 2 5.589 P 0.05 P 0.05), and there was a significant difference between the two groups (蠂 2, 5.589, P 0.05, P 0.05), and the positive expression rate of Bcl-2 in 70 cases of breast cancer was 71.4, which was significantly higher than that in the benign hyperplasia of the breast (蠂 2 5.589 P 0.05). The positive expression rate of Caspase-3 in adenocarcinoma bone metastasis group was 72.5, which was slightly higher than that in breast cancer without bone metastasis group, but there was no significant difference between the two groups (蠂 2, 0.053, P 0.05, P 0.05. 3. The positive expression rate of Caspase-3 in 70 breast cancer tissues was 82.6, slightly higher than that in breast benign hyperplasia group, but the positive expression rate of Caspase-3 in 70 breast cancer tissues was 82.6, but both were higher than those in breast benign hyperplasia group. The positive expression rate of Caspase-3 in breast cancer bone metastasis group was 92.5, which was significantly higher than that in breast cancer without bone metastasis group. The positive expression rate of Bcl-2 was correlated with the expression of ERP PR in patients with bone metastasis of breast cancer (蠂 217.595, P 10.01; 蠂 2 22, 5.021, P 20.05, P 20.05), and was positively correlated with other clinicopathological parameters (age, tumor diameter, axillary lymph node metastasis, P 20.01). The expression of HER-2 and Ki-67 in histopathological grading were not related to the expression of P0. 05. 5. There was no correlation between the positive expression rate of Caspase-3 and the clinicopathologic parameters (age, tumor diameter, axillary lymph node metastasis, histopathological grade of ERP / PRHER-2 and Ki-67 expression) in breast cancer. 6. Bcl-2Caspase-3 expression was not correlated with the expression of P0.05. 7 in breast cancer. The bone metastasis rate of breast cancer with positive expression of Caspase-3 was significantly higher than that of negative group. The difference was statistically significant (蠂 2 + 4.755% P 0.05), and the bone metastasis of breast cancer was related to axillary lymph node metastasis. The rate of bone metastasis in patients with axillary lymph node metastasis was 69.7%, which was significantly higher than that in patients without axillary lymph node metastasis (蠂 2 / 4.018 / P 0.05), and there was no correlation between bone metastasis and other clinicopathological factors (age, tumor diameter, histological grade Bcl-2ERP / PRHER-2 and Ki-67 expression). Conclusion: 1. Bcl-2Caspase-3 is highly expressed in breast cancer tissues, and there is no correlation between them, suggesting that the apoptosis pathway mediated by Bcl-2Caspase-3 plays an important role in the occurrence and development of breast cancer. 2. There was no difference between the expression of Bcl-2 in breast cancer with or without bone metastasis, but it was positively correlated with ERP. The results suggest that the expression of Bcl-2 may be one of the bases for the selection of endocrine therapy in patients with bone metastasis of breast cancer. 3. The expression of Caspase-3 is significantly different between the groups with or without bone metastasis of breast cancer, suggesting that the high expression of Caspase-3 is related to bone metastasis of breast cancer. As with axillary lymph node metastasis, it may be a risk factor for bone metastasis in breast cancer.
【學(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.9

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