【摘要】：目的:食管鱗癌是人類最常見的消化道惡性腫瘤之一,確切的發(fā)病機(jī)制至今尚不明確,普遍認(rèn)為與生活習(xí)慣、飲酒、吸煙、遺傳以及環(huán)境社會等因素有關(guān)。研究發(fā)現(xiàn)Kiss-1和PPARγ基因在人類多種惡性腫瘤發(fā)生發(fā)展過程中發(fā)揮了重要作用。目前,關(guān)于Kiss-1和PPARγ與食管鱗癌之間的關(guān)系的研究尚無較多報道。本研究選擇Kiss-1和PPARγ兩種基因作為研究內(nèi)容,利用實時定量熒光PCR法檢測兩種基因在食管鱗癌組織及正常食管黏膜組織中的表達(dá)情況,并分析兩種基因與食管鱗癌患者臨床病理資料之間的關(guān)系,借以探討其在食管鱗癌發(fā)生中的作用及臨床意義。方法:1收集2012年1月~2015年12月,河北醫(yī)科大學(xué)第一醫(yī)院、河北醫(yī)科大學(xué)第四醫(yī)院手術(shù)切除的食管鱗癌組織標(biāo)本40例(患者術(shù)前均未接受任何形式的化療和放療)。每例標(biāo)本分別取自食管鱗癌原發(fā)腫瘤組織及切緣正常黏膜(正常黏膜組織由術(shù)后病理證實,均無癌組織侵犯)。腫瘤組織切除后迅速置于液氮中短暫保存,隨后置于-80℃超低溫冷凍儲存箱保存。2利用實時定量熒光PCR方法檢測40例食管鱗癌及食管正常黏膜組織中Kiss-1與PPARγ的表達(dá)水平,比較兩種基因在組間表達(dá)的差異,分析Kiss-1與PPARγ的表達(dá)與食管鱗癌患者臨床病理特征的關(guān)系。3采用SPSS19.0及GraphPad Prism 5.0統(tǒng)計軟件進(jìn)行數(shù)據(jù)的計算及統(tǒng)計分析,非正態(tài)分布的數(shù)據(jù)以中位數(shù)(四分位數(shù))表示,兩組間配對樣本采用非參數(shù)檢驗,以P0.05表示差異存在有統(tǒng)計學(xué)意義。結(jié)果:1 Kiss-1在40例食管鱗癌組織中表達(dá)水平為0.0256(0.0090,0.0965),正常食管黏膜中表達(dá)水平為0.0781(0.0424,0.3108),說明Kiss-1在食管鱗癌組織中的表達(dá)水平明顯低于正常食管黏膜(P0.05),差異具有統(tǒng)計學(xué)意義;2 Kiss-1在有淋巴結(jié)轉(zhuǎn)移的食管鱗癌組織中表達(dá)水平為0.0110(0.0056,0.0300),明顯低于無淋巴結(jié)轉(zhuǎn)移的食管鱗癌組織中的表達(dá)水平0.0591(0.0230,0.2405)(P0.01);Kiss-1的表達(dá)與其他病理學(xué)資料無明顯關(guān)系,差異無統(tǒng)計學(xué)意義(P0.05);3 PPARγ在40例食管鱗癌組織中表達(dá)水平為0.2624(0.0677,0.5715),正常黏膜組織中表達(dá)水平為0.5280(0.1225 1.1839),說明PPARγ在食管鱗癌組織中的表達(dá)水平明顯低于正常食管黏膜(P0.05),差異具有統(tǒng)計學(xué)意義;4 PPARγ在有淋巴結(jié)轉(zhuǎn)移的食管鱗癌組織中表達(dá)水平為0.1797(0.0570,0.3668)明顯低于無淋巴結(jié)轉(zhuǎn)移的食管鱗癌組織中的表達(dá)水平為0.4333(0.0743,0.8477)(P0.05);PPARγ在低分化的食管鱗癌組織中表達(dá)水平為0.0535(0.0239,0.0787)明顯低于中高分化的食管鱗癌組織中的表達(dá)水平為0.4076(0.1866,0.7157)(P0.01);PPARγ的表達(dá)與其他病理學(xué)資料無明顯關(guān)系,差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1 Kiss-1和PPARγ在食管鱗癌組織中均呈現(xiàn)低表達(dá),提示其在食管鱗癌的發(fā)生、發(fā)展中可能具有抑癌作用。2 Kiss-1在有淋巴結(jié)轉(zhuǎn)移組中表達(dá)水平明顯低于無淋巴結(jié)轉(zhuǎn)移組,提示Kiss-1在食管鱗癌發(fā)展過程中可能起到抑制腫瘤轉(zhuǎn)移的作用。3 PPARγ在有淋巴結(jié)轉(zhuǎn)移組中表達(dá)水平明顯低于無淋巴結(jié)轉(zhuǎn)移組,在低分化食管鱗癌組織中表達(dá)水平明顯低于中高分化組,提示PPARγ的表達(dá)水平對食管鱗癌預(yù)后判斷具有一定的臨床價值。
[Abstract]:Objective: esophageal squamous cell carcinoma is one of the most common malignant tumor of the digestive tract in human. The exact pathogenesis is still unclear. It is generally believed that it is related to living habits, drinking, smoking, heredity and environmental society. The study found that Kiss-1 and PPAR gamma play an important role in the development of various human malignant tumors. The study of the relationship between Kiss-1 and PPAR gamma and esophageal squamous cell carcinoma has not been reported. This study selected two genes of Kiss-1 and PPAR gamma as research contents. The expression of two genes in esophageal squamous cell carcinoma and normal esophageal mucosa was detected by real-time quantitative fluorescent PCR, and two genes were analyzed with esophageal squamous cell carcinoma. The relationship between clinicopathological data is to explore its role and clinical significance in the occurrence of squamous cell carcinoma of the esophagus. Methods: 1 in January 2012, December ~2015, the first hospital of Hebei Medical University, and 40 cases of esophageal squamous cell carcinoma excised by the fourth hospital of Hebei Medical University (no form of chemotherapy and radiotherapy were accepted before the operation). Each specimen was taken from the primary tumor tissue of the squamous cell carcinoma of the esophagus and the normal mucous membrane of the cutting edge (normal mucosa was confirmed by postoperative pathology, all of which had no cancer tissue). After the resection of the tumor, the tumor tissues were quickly stored in the liquid nitrogen, and then placed in the cryopreservation storage tank at -80 C and stored in the.2 for the detection of 40 cases of esophageal scales with real-time quantitative fluorescence PCR The expression level of Kiss-1 and PPAR gamma in the normal mucosa of cancer and esophagus, the difference of the expression between the two genes was compared. The relationship between the expression of Kiss-1 and PPAR gamma and the clinicopathological features of the patients with esophageal squamous cell carcinoma were calculated and analyzed by SPSS19.0 and GraphPad Prism 5 statistical software, and the data of non normal distribution were obtained. The median (four digits) indicated that there was a statistical difference between the two pairs of paired samples and P0.05. Results: the expression level of 1 Kiss-1 in 40 cases of esophageal squamous cell carcinoma was 0.0256 (0.0090,0.0965), and the expression level in normal esophageal mucosa was 0.0781 (0.0424,0.3108), indicating the table of Kiss-1 in the squamous cell carcinoma of the esophagus. The difference was statistically significant lower than that of normal esophageal mucosa (P0.05), and the expression level of 2 Kiss-1 in esophageal squamous cell carcinoma with lymph node metastasis was 0.0110 (0.0056,0.0300), which was significantly lower than that of esophageal squamous cell carcinoma without lymph node metastasis (0.0230,0.2405) (P0.01), and the expression of Kiss-1 and other pathological funds were significantly lower than that of non lymph node metastases (P0.01). There was no significant difference in material relationship (P0.05), and the expression level of 3 PPAR gamma in 40 cases of esophageal squamous cell carcinoma was 0.2624 (0.0677,0.5715), and the expression level in normal mucosa tissue was 0.5280 (0.1225 1.1839), indicating that the expression level of PPAR gamma in esophageal squamous cell carcinoma was significantly lower than that of normal esophageal mucosa (P0.05). The difference was statistically significant. 4 PPAR gamma expression level of 0.1797 (0.0570,0.3668) in esophageal squamous cell carcinoma with lymph node metastasis was 0.4333 (0.0743,0.8477) (P0.05), and the expression level of PPAR gamma in low differentiated squamous cell carcinoma was 0.0535 (0.0239,0.0787) significantly lower than that of medium high differentiation. The expression level in the squamous cell carcinoma tissue was 0.4076 (0.1866,0.7157) (P0.01), and the expression of PPAR gamma had no significant relationship with other pathological data, and the difference was not statistically significant (P0.05). Conclusion: 1 Kiss-1 and PPAR gamma showed low expression in the squamous cell carcinoma of the esophagus, suggesting that it may be in the development of squamous cell carcinoma of the esophagus, and it may have the tumor suppressor action of.2 Kiss-1 in the development. The expression level in the lymph node metastasis group was significantly lower than that in the non lymph node metastasis group, suggesting that Kiss-1 may play a role in inhibiting tumor metastasis during the development of esophageal squamous cell carcinoma. The expression level of.3 PPAR gamma in the lymph node metastasis group was significantly lower than that in the non lymph node metastasis group, and the expression level in the low differentiated esophageal squamous cell carcinoma was significantly lower than that of the middle high score. Conclusion the expression of PPAR gamma is of clinical value in the prognosis of esophageal squamous cell carcinoma.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.1

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