發(fā)布時(shí)間：2018-08-11 09:00

【摘要】：目的:Coronin3蛋白是脊椎動物七種冠狀蛋白中的一種,是高度保守的,有WD40重復(fù)序列的,可調(diào)節(jié)F-肌動蛋白和Arp2/3復(fù)合物之間的平衡,進(jìn)而影響細(xì)胞肌動蛋白骨架的重組、腫瘤細(xì)胞的運(yùn)動的蛋白。本次實(shí)驗(yàn)在于探索Coronin3蛋白在結(jié)腸癌組織,癌旁組織,肝轉(zhuǎn)移組織中表達(dá)情況,結(jié)合臨床、病理因素進(jìn)一步分析其相關(guān)性。方法:收集并整理2010年1月至2015年12月就診于山西省腫瘤醫(yī)院,經(jīng)術(shù)后病理證實(shí)診斷為同時(shí)性或異時(shí)性大腸癌肝轉(zhuǎn)移,且已行手術(shù)R0切除患者的臨床及病理資料。除外合并多發(fā)轉(zhuǎn)移行姑息性手術(shù)治療,伴嚴(yán)重的內(nèi)科疾病影響患者遠(yuǎn)期生存等,滿足入組條件者。其中收集的臨床資料包括:患者姓名、性別、年齡,合并癥,原發(fā)腫瘤的位置、浸潤深度、大體分型、組織類型、分化程度,陽性淋巴結(jié)數(shù)目,肝轉(zhuǎn)移的數(shù)目、位置、治療方式,是否合并多發(fā)轉(zhuǎn)移,術(shù)后治療措施,隨訪遠(yuǎn)期生存及死亡原因。對于符合入組標(biāo)準(zhǔn)的患者用免疫組織化學(xué)和RT—PCR分別在蛋白水平和信使RNA水平判斷Coronin3蛋白水平的表達(dá),并結(jié)合臨床、病理相關(guān)資料進(jìn)行分析。采用SPSS22.0統(tǒng)計(jì)軟件包對數(shù)據(jù)進(jìn)行處理,計(jì)量資料采用均數(shù),兩組間比較采用Kruskal-Wallis法進(jìn)行檢驗(yàn),計(jì)數(shù)資料采用卡方檢驗(yàn);采用Graph-pad prism進(jìn)行制圖。結(jié)果:1.本次小樣本結(jié)直腸癌同時(shí)伴肝轉(zhuǎn)移的患者中,73%(22/30)的患者大于60歲,男性略多于女性,原發(fā)腫瘤部位以結(jié)腸多見70%(21/30),大體類型以潰瘍型多見,并非所有的原位腫瘤均浸潤組織全層,有1例腫瘤侵出淺肌層即發(fā)生遠(yuǎn)處轉(zhuǎn)移,多數(shù)2.患者陽性淋巴結(jié)數(shù)目超過4枚(N2),有6例無淋巴結(jié)轉(zhuǎn)移,肝轉(zhuǎn)移數(shù)目以3個以下的多見,術(shù)前CEA、AFP多數(shù)未見明顯增高。3.Coronin3蛋白在癌旁組織的陽性率為46%(14/30),癌組織為63%(19/30),在肝轉(zhuǎn)移組織中為67%(20/30)。Coronin3蛋白在癌旁組織中的表達(dá)為2.60±1.38,在原位腫瘤中的表達(dá)為4.43±1.34,在肝轉(zhuǎn)移組織中的表達(dá)為5.12±2.32。Coronin3蛋白的mRNA在癌旁組織中的表達(dá)為0.78±0.12,在原位腫瘤中的表達(dá)為1.43±0.56,在肝轉(zhuǎn)移組織中的表達(dá)為1.52±0.72。相關(guān)性分析表明,Coronin3蛋白在癌旁組織中的表達(dá)明顯低于原位癌組織和肝轉(zhuǎn)移灶,但不能承認(rèn)原位癌組織與肝轉(zhuǎn)移灶間存在明顯差異。4.Coronin3蛋白的表達(dá)與轉(zhuǎn)移瘤的數(shù)目相關(guān)、陽性淋巴結(jié)的數(shù)目、原發(fā)灶的分化程度有關(guān),與患者的年齡、性別無明確相關(guān)性。結(jié)論:1.結(jié)直腸癌伴肝轉(zhuǎn)移可行同時(shí)手術(shù)切除患者,以結(jié)腸癌患者多見,肝臟轉(zhuǎn)移數(shù)目多數(shù)小于3個,病理大體類型以潰瘍型多見。2.Coronin3蛋白在癌旁組織低表達(dá),在癌組織與肝轉(zhuǎn)移灶中高表達(dá),提示其與腫瘤的形成有相關(guān)性。3.Coronin3蛋白的表達(dá)水平,與腫瘤的轉(zhuǎn)移灶、陽性淋巴結(jié)的數(shù)目、原發(fā)腫瘤的分化程度呈相關(guān)性;但是,其在癌組織與癌旁組織無明顯差異。提示其與結(jié)直腸腫瘤的進(jìn)展有關(guān)。
[Abstract]:Objective: the 1: Coronin3 protein is one of seven coronal proteins in vertebrates. It is highly conserved and has WD40 repeats, which can regulate the balance between F- actin and Arp2/3 complex, and then affect the recombination of actin cytoskeleton. A protein that moves tumor cells. The purpose of this study was to investigate the expression of Coronin3 protein in colon cancer, paracancerous tissues and liver metastases, and to further analyze its correlation with clinical and pathological factors. Methods: the clinical and pathological data of patients with liver metastasis from January 2010 to December 2015 in Shanxi Cancer Hospital were collected and analyzed, which were proved to be simultaneous or allogeneic liver metastases by pathology and had been resected by R0 operation. The patients with multiple metastases were treated with palliative operation, and the patients with severe internal medical diseases were affected by the long-term survival. The clinical data collected include: patient's name, sex, age, complication, location of primary tumor, depth of invasion, gross classification, histological type, degree of differentiation, number of positive lymph nodes, number and location of liver metastasis. Treatment, whether with multiple metastasis, postoperative treatment measures, follow-up long-term survival and causes of death. Immunohistochemistry and RT-PCR were used to determine the expression of Coronin3 protein at protein level and messenger RNA level in patients who met the admission criteria. The clinical and pathological data were analyzed. The data are processed by SPSS22.0 statistical software package, the mean is used to measure the data, the Kruskal-Wallis method is used to test the comparison between the two groups, the chi-square test is used to count the data, and the cartography is carried out by Graph-pad prism. The result is 1: 1. In this small sample of colorectal cancer patients with liver metastasis, 73% (22 / 30) of the patients were over 60 years old, male slightly more than female, the primary tumor location was more than 70% (21 / 30) of colon, the gross type was ulcer type, not all in situ tumors infiltrated the whole tissue layer. In one case, distant metastasis occurred in the superficial muscle layer, most of which were 2. 2%. The number of positive lymph nodes was more than 4 (N2), and no lymph node metastasis was found in 6 cases. The positive rate of coronin3 protein was 46% (14 / 30) in adjacent tissues, 63% (19 / 30) in cancer tissues, 67% (20 / 30) in liver metastases, 2.60 鹵1.38 in adjacent tissues, 4.43 鹵1.34 in situ tumors. The expression of mRNA with 5.12 鹵2.32.Coronin3 protein was 0.78 鹵0.12 in paracancerous tissues, 1.43 鹵0.56 in situ tumors and 1.52 鹵0.72 in liver metastases. Correlation analysis showed that the expression of Coronin3 protein in paracancerous tissues was significantly lower than that in carcinoma in situ tissues and liver metastases, but there was no obvious difference between carcinoma in situ and liver metastases. 4. The expression of Coronin3 protein was correlated with the number of metastatic tumors. The number of positive lymph nodes and the degree of differentiation of primary lesions were not correlated with age and sex. Conclusion 1. Colorectal cancer with liver metastasis can be resected at the same time. Colon cancer patients are more common, liver metastasis number is less than 3, and pathological gross type is ulcer type. 2. Coronin3 protein expression is low in adjacent tissues. The high expression of Coronin3 protein in cancer tissues and liver metastases suggests that the expression level of Coronin3 protein is correlated with tumor metastasis, the number of positive lymph nodes and the differentiation degree of primary tumor. There was no significant difference between cancer tissue and paracancerous tissue. It suggests that it is related to the progression of colorectal tumor.
【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】：2017
【分類號】：R735.34

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