發(fā)布時(shí)間：2018-06-10 06:52

  本文選題：雙源癌 + 食管鱗癌��； 參考：《山西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:通過檢測上消化道雙源癌中Her-2蛋白表達(dá)和HPV感染情況,探討了同一系統(tǒng)中不同組織類型的惡性腫瘤在發(fā)生發(fā)展過程中的聯(lián)系及其與臨床病理的關(guān)系;通過對山西省腫瘤醫(yī)院34例上消化道雙源癌患者的臨床病理資料進(jìn)行回顧性分析,研究山西地區(qū)上消化道雙源癌的發(fā)病規(guī)律、診治策略和預(yù)后因子。方法:(1)采用免疫組織化學(xué)法(immunohistochemistry IHC)檢測39例食管、胃雙源癌標(biāo)本中Her-2蛋白的表達(dá)。采用原位雜交技術(shù)(in situ hybridization ISH)對39例食管、胃雙源癌標(biāo)本中HPV-DNA進(jìn)行檢測。(2)收集上消化道雙源癌病例及數(shù)據(jù)處理,分析山西地區(qū)上消化道雙源癌的相關(guān)臨床特征。結(jié)果:(1)Her-2蛋白過表達(dá)與上消化道雙源癌中食管鱗癌的分化程度、浸潤深度、淋巴結(jié)轉(zhuǎn)移及患者的年齡性別均無關(guān),差異無統(tǒng)計(jì)學(xué)意義〔P0.05〕;Her-2蛋白過表達(dá)與上消化道雙源癌中胃腺癌的浸潤深度、淋巴結(jié)轉(zhuǎn)移因素相關(guān),差異有統(tǒng)計(jì)學(xué)意義〔P0.05〕,與患者的年齡、性別及腫瘤的分化程度無關(guān),差異無統(tǒng)計(jì)學(xué)意義〔P0.05〕。(2)HPV感染與上消化道雙源癌中食管鱗癌和胃腺癌的分化程度、浸潤深度、淋巴結(jié)轉(zhuǎn)移及患者的年齡性別均無關(guān),差異無統(tǒng)計(jì)學(xué)意義〔P0.05〕。(3)Her-2蛋白過表達(dá)在上消化道雙源癌腫瘤組織中呈現(xiàn)一致性,Kappa=0.75,P0.05。HPV-DNA在上消化道雙源癌腫瘤組織中也呈現(xiàn)一致性,Kappa=0.80,P0.05.(4)結(jié)合上消化道雙源癌患者臨床資料分析,其預(yù)后與患者年齡、治療方式、以及地區(qū)分布有關(guān)。結(jié)論:(1)Her-2和HPV可能是上消化道雙源癌中食管鱗癌和胃腺癌的共同相關(guān)致病危險(xiǎn)因素。(2).研究發(fā)現(xiàn)山西地區(qū)的上消化道雙源癌有明顯的地域集中分布性,早期診斷后施行同期手術(shù),并結(jié)合放化療等綜合治療可明顯提高療效和改善預(yù)后。
[Abstract]:Objective: to investigate the relationship between the expression of Her-2 protein and HPV infection and the clinicopathology of malignant tumors of different types in the same system by detecting the expression of Her-2 protein and the infection of HPV in the double carcinomas of upper digestive tract. By retrospective analysis of the clinicopathological data of 34 patients with upper gastrointestinal cancer in Shanxi Cancer Hospital, the pathogenesis, diagnosis and treatment strategies and prognostic factors of double source carcinoma of upper digestive tract in Shanxi were studied. Methods the expression of Her-2 protein in 39 cases of esophageal and gastric carcinomas was detected by immunohistochemical method. In situ hybridization (ish) technique was used to detect HPV-DNA in 39 cases of esophageal and gastric carcinomas. Results the overexpression of Her-2 protein was not related to the degree of differentiation, depth of invasion, lymph node metastasis and age and sex of esophageal squamous cell carcinoma. There was no significant difference between the expression of P0.05 and Her-2 protein and the depth of gastric adenocarcinoma invasion and lymph node metastasis, but there was no significant difference between the expression of P0.05and the age, sex and differentiation of the tumor. There was no significant difference between HPV infection and the differentiation, depth of invasion, lymph node metastasis, age and sex of esophageal squamous cell carcinoma and gastric gland carcinoma. There was no significant difference in the overexpression of P0.05, P0. 05 and Her-2 protein in the tumor tissues of double origin carcinoma of upper digestive tract. The clinical data of patients with double carcinomas of upper digestive tract were analyzed in combination with Kappa-0.75 and P0.05. 05. HPV-DNA in the tumor tissues of double carcinomas of upper digestive tract, and the clinical data of patients with double carcinomas of upper digestive tract were also analyzed, and the clinical data of patients with double carcinomas of upper digestive tract were analyzed. The prognosis is related to patient age, treatment style, and regional distribution. Conclusion Her-2 and HPV may be the common risk factors of esophageal squamous cell carcinoma and gastric adenocarcinoma in upper digestive tract carcinomas. The study found that the upper digestive tract double source carcinoma in Shanxi area has the obvious regional concentration distribution, the early diagnosis carries on the simultaneous operation after the early diagnosis, combined with the radiotherapy and chemotherapy and so on comprehensive treatment can obviously enhance the curative effect and the improvement prognosis.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R735

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本文編號：2002352