【摘要】：目的探討Lrig1、EGFR在人體胃癌組織和外周血中的表達情況和臨床意義,以及Lrig1與腫瘤標記物CEA、CA724的聯(lián)合檢測對胃癌的診斷價值分析。方法采用免疫組化二步法檢測Lrig1和EGFR蛋白在57例胃癌組織和相應癌旁正常胃組織中的表達情況,分析其與臨床病理參數的相關性;通過RT-PCR檢測Lri g1和EGFR m RNA在57例胃癌組織中和相應癌旁正常胃組織的相對表達量,以及L rig1 m RNA在57例胃癌患者和健康人外周血中的相對表達量;通過電化學發(fā)光法檢測57例胃癌患者及健康人血清中CEA、CA724的表達水平,并聯(lián)合Lrig1 m RNA在外周血中的表達,對結果進行分析。結果1、Lrig1在胃癌組織中的陽性表達率(38.6%)低于正常胃組織(82.5%),而E GFR在胃癌組織中的陽性表達率(63.2%)顯高于正常胃組織(15.8%),差異具有統(tǒng)計學意義(P0.05)。Lrig1和EGFR蛋白在胃癌組織中的表達水平呈顯著負相關(r=-0.515,P0.01)。Lrig1蛋白的表達與胃癌患者的性別、年齡、腫瘤大小、分化程度、TNM分期和有無淋巴結轉移無關(P0.05),EGFR蛋白表達與患者年齡、性別、腫瘤大小無關(P0.05),而與腫瘤分化程度、TNM分期和有無淋巴結轉移密切相關(P0.01)。2、胃癌組織中Lrig1 m RNA表達水平(0.43±0.16)較相應癌旁正常組織(1.06±0.21)降低,而EGFR m RNA表達水平(3.27±0.67)高于相應癌旁正常組織(1.33±0.28),P0.05。Lrig1和EGFR m RNA在胃癌組織中的表達水平呈顯著負相關(r=-0.874,P0.01)。3、胃癌患者靜脈血中Lrig1 m RNA表達水平(0.73±0.21)較健康對照組(1.28±0.27)降低(P0.05)。4、胃癌患者血清CEA(39.6±16.5)、CA724(58.8±19.6)水平明顯高于對照組CEA(3.3±1.2)、CA724(4.5±1.7),P0.05,且胃癌患者血清中CE A(54.4%)、CA724(73.7%)陽性率明顯高于對照組CEA(14.0%)、CA724(8.8%),P0.05,胃癌患者靜脈血中Lrig1 m RNA的表達陽性率(49.1%)明顯低于對照組(87.7%),P0.05。Lrig1和CEA、CA724在胃癌患者靜脈血中和健康對照組靜脈血中的表達水平呈負相關(r=-0.509,P0.01;r=-0.369,P0.01)。Lrig1和CEA、CA724三者聯(lián)合檢驗的敏感性和特異性高于單一檢測的結果。結論1、Lrig1在胃癌組織中存在低表達,提示Lrig1在參與胃癌的發(fā)生發(fā)展過程中可能起著抑癌基因的作用,其表達并不能決定胃癌的病理分型;EGFR在胃癌組織中的高表達提示EGFR可能在胃癌的發(fā)病機制中和生長增殖中發(fā)揮關鍵作用。2、胃癌組織中Lrig1與EGFR的表達呈負相關,提示Lrig1可能存在對EGFR的負反饋調節(jié),二者在正常情況下保持一定的平衡。3、腫瘤標志物CEA和CA724對胃癌均有一定的敏感性和特異性,Lrig1 m R NA與其聯(lián)合檢測提高了對胃癌診斷的敏感性和特異性,這對胃癌的早期防治和跟蹤治療有很大的參考價值。
[Abstract]:Objective to investigate the expression and clinical significance of Lrig1,EGFR in human gastric cancer tissues and peripheral blood, and to analyze the diagnostic value of Lrig1 combined with tumor marker CEA,CA724 in gastric cancer. Methods Immunohistochemical two-step method was used to detect the expression of Lrig1 and EGFR protein in 57 cases of gastric cancer and adjacent normal gastric tissues, and the correlation between the expression and clinicopathological parameters was analyzed. The relative expression of Lri G1 and EGFR m RNA in 57 cases of gastric cancer and the corresponding normal gastric tissues were detected by RT-PCR, and the relative expression of L rig1 m RNA in peripheral blood of 57 cases of gastric cancer and healthy persons was also detected. The expression of CEA,CA724 in serum of 57 patients with gastric cancer and healthy persons was detected by electrochemiluminescence, and the expression of Lrig1 m RNA in peripheral blood was analyzed. Results 1the positive expression rate of Lrig1 in gastric cancer tissues (38.6%) was lower than that in normal gastric tissues (82.5%), while the positive expression rate of E GFR in gastric cancer tissues (63.2%) was significantly higher than that in normal gastric tissues (15.8%). The difference was statistically significant (P0.05). There was a significant negative correlation between the expression of Lrig1 and EGFR in gastric cancer tissues (r-0.515, P0.01). The expression of Lrig1 protein was correlated with the sex, age, tumor size, differentiation degree of gastric cancer patients. TNM stage was not related to lymph node metastasis (P0.05), EGFR protein expression was not related to age, sex and tumor size (P0.05), but was closely related to tumor differentiation, TNM stage and lymph node metastasis (P0.01). The expression of Lrig1 m RNA in gastric cancer (0.43 鹵0.16) was significantly lower than that in adjacent normal tissues (1.06 鹵0.21), while the expression of EGFR m RNA was (3.27 鹵0.67) higher than that in adjacent normal tissues (1.33 鹵0.28). The expression of P0.05.Lrig1 and EGFR m RNA in gastric carcinoma was negatively correlated (r = -0.874, P 0.01). The expression of Lrig1 m RNA in the venous blood of gastric cancer patients (0.73 鹵0.21) was significantly lower than that in the healthy controls (1.28 鹵0.27) (P0.05), and the serum CEA level in gastric cancer patients was (39.6 鹵16.5). The levels of CA724 (58.8 鹵19.6) were significantly higher than those of control group (3.3 鹵1.2), CA724 (4.5 鹵1.7), P0.05, and the serum CE A (of gastric cancer patients was 54.4%. The positive rate of CA724 (73.7%) was significantly higher than that of control group (14.0%), CA724 (8.8%), P0.05. The positive rate of Lrig1 m RNA expression in venous blood of gastric cancer patients (49.1%) was significantly lower than that of control group (87.7%). There was a negative correlation between the expression of P0.05.Lrig1 and CEA,CA724 in the venous blood of gastric cancer patients and the healthy control group (r = -0.509, P 0.01). The sensitivity and specificity of Lrig1 and CEA,CA724 combined detection were higher than that of single detection. Conclusion 1 the low expression of Lrig1 in gastric carcinoma suggests that Lrig1 may play an important role in the carcinogenesis and development of gastric cancer, and its expression can not determine the pathological type of gastric cancer. The high expression of EGFR in gastric cancer suggests that EGFR may play a key role in the pathogenesis and growth of gastric cancer. 2There is a negative correlation between Lrig1 and EGFR expression in gastric cancer, suggesting that Lrig1 may have negative feedback regulation on EGFR. The tumor markers CEA and CA724 have a certain sensitivity and specificity for gastric cancer. The combined detection of Lrig1 m R NA and CA724 improves the sensitivity and specificity of the diagnosis of gastric cancer. It has great reference value for early prevention and treatment of gastric cancer.
【學位授予單位】：遼寧醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R735.2

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