Survivin基因表达和K-ras基因突变表达在大肠癌中的关系及对预后的影响

发布时间：2018-06-11 23:54

本文选题：大肠癌 + Survivin　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:利用免疫组织化学方法对K-ras和Survivin蛋白在大肠癌中的表达进行检测,利用直接测序法对K-ras基因突变进行检测,并对这些患者进行至少5年随访,整理临床资料,初步探讨探究Survivin基因的表达与K-ras基因突变和表达之间关系,研究对预后的影响和其与临床病理参数的相关性。实验材料与方法:选取2010年3月至2011年11月期间在吉林大学白求恩第一医院胃结直肠外科行大肠癌根治术的患者53例,并进行5年术后随访,实验组为此53例患者癌组织标本,对照组为53例患者癌旁大于5cm的正常组织标本(术后病理已经证实为正常组织),于病理科和组织标本库选取相应的组织标本。对临床资料按组织学分型、脉管浸润、T分期等进行整理。检测组织标本中Survivin及K-ras蛋白的表达应用免疫组织化学方法,K-ras基因突变应用直接测序法。数据结果的处理应用SPSS 22.0统计软件,利用χ2检验对计数资料进行统计分析,相关性分析应用Spearman相关性分析法,对生存情况的分析应用Kaplan-Meier方法,检验标准为α=0.05,当P0.05时差异具有统计学意义。结果:1、在大肠癌中Survivin蛋白的表达高于癌旁正常组织(P0.05),并且其蛋白表达与T分期、组织学分型及淋巴结是否转移具有相关性(P0.05),而与年龄、性别、脉管浸润等其他临床病理参数没有相关性(P0.05)。2、在大肠癌中K-ras蛋白的表达高于癌旁正常组织(P0.05),并且该蛋白的表达与患者的淋巴结是否转移及脉管是否浸润具有相关性(P0.05),而与患者的年龄、性别、组织学分型及T分期等没有相关性(P0.05)。3、K-ras基因突变率为39.62%,且与淋巴结转移具有相关性(P0.05),而与患者的年龄、性别、组织学分型及脉管浸润、T分期等没有相关性(P0.05)。4、在大肠癌组织中Survivin、K-ras蛋白的表达不相关(r=0.223,P0.05),Survivin蛋白的表达与K-ras基因突变具有相关性(χ2=9.877,P0.05)。5、在对大肠癌患者5年生存率的生存分析比较中,K-ras、Survivin蛋白阳性表达组生存率明显低于阴性表达组,差异具有统计意义(P0.05)。结论:1、在大肠癌肿瘤组织中Survivin、K-ras蛋白的表达与癌旁正常组织中存在差异性。2、Survivin、K-ras基因的表达可能是相互独立地影响着大肠癌的发展进程,有待进一步进行研究。3、Survivin基因高表达与K-ras基因突变具有相关性,共同促进大肠癌的发展、浸润和转移。4、大肠癌根治术后的患者预后情况与K-ras和Survivin蛋白高表达具有相关性。
[Abstract]:Objective: to detect the expression of K-ras and survivin protein in colorectal carcinoma by immunohistochemical method and to detect K-ras gene mutation by direct sequencing. To explore the relationship between the expression of survivin gene and K-ras gene mutation and expression, to study the influence on prognosis and the correlation between survivin gene expression and clinicopathological parameters. Materials and methods: from March 2010 to November 2011, 53 patients underwent radical resection of colorectal cancer in Bai Qiuen first Hospital of Jilin University, and followed up for 5 years. In the control group, 53 normal tissues were found to be larger than 5cm in the adjacent tissues (pathology has been proved to be normal tissue after operation), and the corresponding tissue specimens were selected from the pathology department and the tissue specimen bank. The clinical data were arranged according to histological classification and T stage of vascular invasion. The expression of survivin and K-ras protein in tissue samples was detected by immunohistochemical method and K-ras gene mutation was directly sequenced. SPSS22.0 statistical software was used to analyze the data, 蠂 2 test was used to analyze the counting data, Spearman correlation analysis was applied to the correlation analysis, Kaplan-Meier method was used to analyze the survival situation. The test standard was 伪 -0. 05, and the difference was statistically significant when P 0. 05. Results the expression of survivin protein in colorectal carcinoma was higher than that in adjacent normal tissues (P 0.05). The expression of survivin protein was correlated with T stage, histological type and lymph node metastasis, but with age and sex. The expression of K-ras protein in colorectal carcinoma was higher than that in adjacent normal tissue (P0.05), and the expression of K-ras protein was correlated with lymph node metastasis and vascular invasion. P 0. 05, while with the patient's age, There was no correlation between sex, histological classification and T stage. The mutation rate of K-ras gene was 39.62%, and it was correlated with lymph node metastasis (P 0.05), but with age and sex. There was no correlation between histological classification and vascular infiltrating T stage (P0.05A. 4). There was no correlation between the expression of survivin K-ras protein and K-ras gene mutation in colorectal cancer tissues (蠂 ~ 2 / 9.877 / P 0.05. 5). The survival score of 5 years survival rate in colorectal cancer patients was significantly higher than that in control group (蠂 ~ 2 / 9.877% P 0.05. 5), while the expression of survivin protein was not related to the expression of survivin protein in colorectal cancer tissues. The expression of survivin protein was correlated with the mutation of K-ras gene. The survival rate of the positive expression group was significantly lower than that of the negative expression group. The difference was statistically significant (P 0.05). Conclusion the expression of survivin K-ras protein in colorectal cancer tissues is different from that in adjacent normal tissues. The expression of survivin K-ras gene may affect the progression of colorectal cancer independently. The overexpression of survivin gene and the mutation of K-ras gene are related to the development, invasion and metastasis of colorectal cancer. The prognosis of patients with colorectal cancer after radical operation is correlated with the overexpression of K-ras and survivin protein.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34

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