研究背景胃腺癌是胃癌的一種,源于胃腺體細(xì)胞惡化,占全部胃癌發(fā)病率的95%。早期診斷可明顯改善癌癥治療效果,但現(xiàn)實卻是由于缺乏早期診斷手段,往往就診時多數(shù)患者已經(jīng)處于局部晚期或發(fā)生了遠(yuǎn)處轉(zhuǎn)移從而延誤了病情,錯失最佳的治療時機(jī)。血清腫瘤標(biāo)志物以其簡便、快捷、無痛苦等優(yōu)點(diǎn),成為胃癌患者的理想檢查指標(biāo),目前臨床常見的胃癌輔助診斷中有癌胚抗原（CEA）、糖類抗原125（CA125）及糖類抗原199（CA19-9）。盡管多種腫瘤標(biāo)志物聯(lián)合檢測能夠在一定程度上提高早期胃癌診斷的敏感度,可用于預(yù)測患者的病情進(jìn)展和預(yù)后,但檢測重復(fù)性不佳。組合應(yīng)用表面增強(qiáng)激光解析電離飛行時間質(zhì)譜（SELDI-TOF-MS）、高效液相色譜（HPLC）及基質(zhì)輔助激光解析附電離飛行時間質(zhì)譜（MALDI-TOF-MS）技術(shù),課題組前期曾成功在乳頭狀甲狀腺癌及乳腺癌中尋找特異性標(biāo)志物,對相關(guān)腫瘤早期診斷及預(yù)后檢測有參考意義,但前期實驗存在以下問題:a)血清特異性標(biāo)志物未與臨床在使用的腫瘤標(biāo)志物做對比;b)特異性標(biāo)志物未排除炎癥干擾;c)血清分析測試前各種影響因素存在偏差,且相互不獨(dú)立,影響檢驗效能。盡管近年來分子生物標(biāo)志物的發(fā)現(xiàn)急... 

【文章來源】：鄭州大學(xué)河南省 211工程院校

【文章頁數(shù)】：133 頁

【學(xué)位級別】：博士

【部分圖文】：

圖１探索組及測試組患者的生存資料及探索?

圖２探索組不同血清及胃癌不同分期中ｍ／Ｚ?６４４９?Ｄａ蛋白質(zhì)譜圖、模擬電泳圖及表達(dá)強(qiáng)度??圖。注：Ｃｏｎ－ｈ：正常對照，Ｃｏｎ－ｇ：胃炎對照，ＧＣ－ｐｒｅ：胃癌術(shù)前，ＧＣ－ｐｏｓ：胃癌術(shù)后，??ＧＣ－ｒｅｌ：胃癌復(fù)發(fā)；ＧＣ－丨：丨期胃癌，ＧＣ－丨丨：１丨期胃癌，ＧＣ－丨丨丨：丨丨１期胃癌，ＧＣ－ＩＶ：?ＩＶ期??胃癌。＊ｐ＜０．０５。??３．?２判別模型盲法驗證??為驗證上述得到的判別模型的準(zhǔn)確性和可行性，本研宄用測試組［６０例胃癌??１９??

?第一部分：胃腺癌非炎癥性血清標(biāo)志物的篩選、鑒定及驗證???同時檢測６４４９?Ｄａ在胃癌血清及組織中的表達(dá)情況，結(jié)果發(fā)現(xiàn)：血清ＷＢ：與對??照組相比，ｍ／ｚ６４４９Ｄａ蛋白在術(shù)前組高表達(dá)，術(shù)后纟且低表達(dá)，復(fù)發(fā)組又表達(dá)上??調(diào)（對照，０．３０６±０．１３８?ｖｓ?術(shù)前，１．０７５±０．１２３?ｖｓ?術(shù)后，０．５１２士０．１４８?ｖｓ?復(fù)發(fā)，??０．７７８±０．１０６；ｐ＜０．０５；圖?３Ｆ，?Ｇ）；血清?ＥＬＩＳＡ?結(jié)果與血清?ＷＢ?結(jié)果相一致，ｍ／ｚ??６４４９?Ｄａ蛋白在術(shù)前組高表達(dá)，術(shù)后組低表達(dá)，復(fù)發(fā)組又表達(dá)上調(diào)（對照，??０．５１６±〇．１８２ｖｓ?術(shù)前，２．０４３±０．９４０?ｖｓ?術(shù)后，１．１６５±０．４４２?ｖｓ?復(fù)發(fā)，１．５１８±０．３０９；??ｐ＜０．０５；圖３Ｈ）；組織ＷＢ：?ｍ／ｚ?６４４９?Ｄａ蛋白表達(dá)在胃癌上皮與對照上皮組織??之間表達(dá)無統(tǒng)計學(xué)差異（對照，０．１７５?±?０．０２７?ｖｓ胃癌，０．１８２?±?０．０７８；?ｔ＝??０．０８９，ｐ＝０．９３４；圖?４Ａ，Ｂ）；組織?ＥＬＩＳＡ?結(jié)果與組織?ＷＢ?結(jié)果相一致，ｍ／ｚ６４４９Ｄａ??蛋白表達(dá)在胃癌上皮與對照上皮組織之間表達(dá)無統(tǒng)計學(xué)差異（對照，０．２６７±０．０３１??ｖｓ?胃癌，０．３０８?±０．１９６；?ｔ＝ｌ．７８９，ｐ＝０．０７６；圖?４Ｃ）。??￣Ｋ?［Ｂ?ｒｃ－??－－

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