【摘要】：膀胱癌是一種在世界范圍內(nèi)泌尿系惡性腫瘤中最常見的腫瘤,排在惡性腫瘤的第11位,發(fā)病率男性患者排在第7位,在女性患者中排在第10位。在我國,男性膀胱癌發(fā)病率在全身惡性腫瘤中排第7位,多是膀胱尿路上皮癌,占所有病理類型的90%,此外還有腺細胞癌和鱗狀細胞癌等。血尿是膀胱癌最常見的癥狀,尤其是間歇性無痛性肉眼血尿,也可能會合并尿頻,尿急等膀胱刺激癥狀及下腹部疼痛。膀胱鏡檢查及活檢是診斷膀胱癌最可靠的方法。根據(jù)臨床不同的特征膀胱癌的治療也不同,手術現(xiàn)在是膀胱癌外科主要的治療方法。容易復發(fā),多發(fā)是膀胱腫瘤最顯著的生物學行為,浸潤、轉移及腫瘤血管生成幾乎貫穿于膀胱癌的整個發(fā)展過程。目前,腫瘤血管密度已成為判斷膀胱癌預后的獨立指標,高血管密度是腫瘤復發(fā)的危險因素,膀胱癌浸潤性生長依賴于血管生成,因此,探討膀胱癌血管生成相關的分子機制,有助于開發(fā)阻斷或延緩膀胱癌進展的重要分子靶向藥物。目的:觀察EDIL3在不同的分級、分期的膀胱移行細胞癌組織及癌旁組織中的表達狀況,探索EDIL3在膀胱尿路上皮癌發(fā)生、發(fā)展中的作用及與血管內(nèi)皮生長因子(VEGF)表達的關系,為膀胱癌的診斷和治療提供幫助。方法:選用免疫組織化學PV9001二步法觀察24例膀胱癌旁組織、57例膀胱尿路上皮癌組織中EDIL3基因及VEGF基因的表達狀況,結合病理分級及分期進行統(tǒng)計并分析兩個基因表達的相關性。結果:1.膀胱癌細胞中EDIL3基因陽性表達率顯著高于癌旁組織,分別為43.9%(25/57),16.7%(4/24),表達有明顯差異,P0.05,有統(tǒng)計學差異。2.EDIL3基因的表達與患者年齡、體重、發(fā)病時間、腫塊體積、有無吸煙史及腫塊個數(shù)均無相關性(P0.05),但與膀胱癌細胞浸潤的層次深度即腫瘤的病理分期有相關性(P0.05)。3.各病理學分級高表達率為1級15.8%(3/19),2級62.5%(10/16),3級66.7%(12/18)。需注意的是腫瘤的病理分級中,EDIL3基因的表達隨膀胱癌惡性級別的增高而表達強度增加,2級與1級相比具有顯著統(tǒng)計學差異(P0.05),3級與1級相比具有顯著統(tǒng)計學差異(P0.05),但是3級與2級的差別無統(tǒng)計學意義(P0.05)。4.EDIL3和VEGF的表達呈正相關(rS=0.239,P0.05),膀胱癌組織中均呈上升趨勢。結論:EDIL3基因的表達與膀胱癌病理分級,分期及血管內(nèi)皮生長因子相關基因的表達有相關性,可能與膀胱癌的發(fā)生、發(fā)展有重要關聯(lián)。EDIL3檢測可以對判斷腫瘤的浸潤深度和惡性程度提供一定的幫助。
[Abstract]:Bladder cancer is the most common malignant tumor of urinary system in the world, ranking 11th among malignant tumors, 7th in male patients and 10th in female patients. In China, the incidence of bladder cancer in men ranks 7th in the total malignant tumor, mostly bladder urothelial carcinoma, accounting for 90% of all pathological types, in addition to adenocarcinoma and squamous cell carcinoma and so on. Hematuria is the most common symptom of bladder cancer, especially intermittent painless hematuria. Cystoscopy and biopsy are the most reliable methods for the diagnosis of bladder cancer. Surgery is now the main surgical treatment for bladder cancer according to its clinical characteristics. It is easy to recur and multiple is the most significant biological behavior of bladder cancer. Invasion metastasis and tumor angiogenesis almost run through the development of bladder cancer. At present, tumor vascular density has become an independent index to judge the prognosis of bladder cancer. High vascular density is a risk factor for tumor recurrence. Invasive growth of bladder cancer depends on angiogenesis. It helps to develop important molecular targeting drugs that block or delay the progression of bladder cancer. Objective: to observe the expression of EDIL3 in bladder transitional cell carcinoma (TCC) and adjacent tissues in different grades and stages, and to explore the role of EDIL3 in the occurrence and development of bladder urothelial carcinoma and its relationship with the expression of vascular endothelial growth factor (VEGF) (VEGF). To provide help for the diagnosis and treatment of bladder cancer. Methods: the expression of EDIL3 gene and VEGF gene in 24 cases of bladder adjacent tissues and 57 cases of bladder urothelial carcinoma were observed by immunohistochemical PV9001 two-step method. Combined with pathological grading and staging, the correlation between the two genes expression was analyzed. Results: 1. The positive expression rate of EDIL3 gene in bladder cancer cells was significantly higher than that in adjacent tissues (43.9% (25 / 57) and 16.7% (4 / 24), respectively). There was no correlation between the expression of 2.EDIL3 gene and age, weight, onset time, mass volume, smoking history and the number of masses (P0.05). However, there was a correlation between the depth of bladder cancer cell infiltration and the pathological stage of the tumor (P0.05). The high expression rates were 15.8% (3 / 19) in grade 1, 62.5% (10 / 16) in grade 2 and 66.7% (12 / 18) in grade 3. It should be noted that the expression of EDIL3 gene increased with the increase of malignant grade of bladder cancer, and there was significant difference between grade 2 and grade 1 (P0.05). There was significant difference between grade 3 and grade 1 (P0.05), but there was no significant difference between grade 3 and grade 2 (P0.05). The expression of 4.EDIL3 and VEGF was positively correlated (rS=0.239,P0.05). There was an increasing trend in bladder cancer tissues. Conclusion: the expression of EDIL3 gene is correlated with the pathological grade, stage and VEGF-related gene expression of bladder cancer, and may be associated with the occurrence of bladder cancer. EDIL3 can be helpful in determining the depth of invasion and the degree of malignancy of the tumor.
【學位授予單位】：蘭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.14

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