不同超声分型前列腺癌K-ras、EGFR、MMP2、MMP9表达特点的研究

发布时间：2018-03-01 08:51

本文关键词： 经直肠多普勒超声前列腺癌分型组织分化浸润转移蛋白表达　出处：《大连医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：本文旨在通过对不同超声分型的前列腺癌结合病理及K-ras、EGFR、MMP2及MMP9表达情况的研究，探讨各超声分型前列腺癌组织分化及浸润转移的特点，从而通过应用经直肠彩色多普勒超声来判断各超声分型前列腺癌的发生发展及预后，，为临床诊断治疗方案的制定提供更可靠的理论依据。方法：2012年3月～2014年1月期间在我院行超声引导下前列腺穿刺活检的前列腺疾病病例共138例，其中病理确诊为前列腺癌74例，前列腺上皮内瘤变（prostatintraepithelial neoplasia PIN）25例，前列腺增生39例。①收集74例前列腺癌病例经直肠二维及三维超声图像资料，进行回顾性统计分析，借鉴以往徐萍的研究，将所收集的前列腺癌超声图像按照单纯结节型、结节浸润型、弥漫浸润型进行分型；在病理组织分化、浸润转移程度及与PIN、前列腺增生病例间的差异等方面，对不同超声分型前列腺癌加以比较；②对病理组织学标本行免疫组化染色，研究并比较各组前列腺癌、PIN及增生组织中K-ras、EGFR、MMP2及MMP9蛋白表达情况。结果：①单纯结节型（30例）：低分化腺癌4例、转移0例；结节浸润型（20例）：低分化腺癌14例、转移15例；弥漫浸润型（24例）：低分化腺癌20例、转移19例。结节浸润型及弥漫浸润型前列腺癌中的低分化腺癌病例及浸润转移（C+D期）病例所占的比率明显高于单纯结节型（P＜0.05），但前二者无明显差异（P＞0.05）。②三种分型前列腺癌及PIN组中K-ras蛋白表达阳性率及强阳性率和EGFR蛋白表达阳性率较增生组均明显增高（P＜0.05）；结节浸润型和弥漫浸润型前列腺癌中K-ras蛋白表达阳性率及强阳性率和EGFR蛋白表达阳性率较单纯结节型及PIN组也明显增高（P＜0.05）；单纯结节型前列腺癌中K-ras蛋白表达阳性率及强阳性率和EGFR蛋白表达阳性率与PIN组无明显差异（P＞0.05）；结节浸润型与弥漫浸润型前列腺癌中K-ras蛋白表达阳性率及强阳性率和EGFR蛋白表达阳性率均无明显差异（P＞0.05）。③三种分型前列腺癌及PIN组中MMP2蛋白表达阳性率和MMP9蛋白表达阳性率及强阳性率较增生组均明显增高（P＜0.05）；结节浸润型和弥漫浸润型前列腺癌中MMP2蛋白表达阳性率和MMP9蛋白表达阳性率及强阳性率较单纯结节型及PIN组也明显增高（P＜0.05）；单纯结节型前列腺癌的MMP2蛋白表达阳性率和MMP9蛋白表达阳性率及强阳性率与PIN组无明显差异（P＞0.05）；结节浸润型与弥漫浸润型前列腺癌MMP2蛋白表达阳性率和MMP9蛋白表达阳性率及强阳性率均无明显差异（P＞0.05）。结论：前列腺癌的发生发展过程中，单纯结节型前列腺癌的分化程度较高且无远处转移，其恶性度较低，组织特性方面与PIN结节较接近，故可以考虑随诊观察，待机处理；结节浸润型与弥漫浸润型前列腺癌的分化程度较低，且易发生远处转移，其恶性度较高，故建议应尽早行手术治疗。
[Abstract]:Objective: to investigate the characteristics of differentiation, invasion and metastasis of prostate cancer by studying the expression of MMP2 and MMP9 in prostate cancer with different types of ultrasound. Therefore, transrectal color Doppler ultrasound was used to judge the occurrence, development and prognosis of prostate cancer, and to provide a more reliable theoretical basis for clinical diagnosis and treatment. Methods: from March 2012 to January 2014, a total of 138 patients with prostatic diseases underwent ultrasound guided prostatic biopsy in our hospital, including 74 cases of prostate cancer and 74 cases of prostatic intraepithelial neoplasia PIN)25. Thirty-nine cases of benign prostatic hyperplasia (BPH) were collected from 74 cases of prostate cancer by transrectal two-dimensional and three-dimensional ultrasound images. The data were statistically analyzed retrospectively. According to the previous studies of Xu Ping, the collected ultrasound images of prostate cancer were classified as simple nodular type. Nodular infiltrative type, diffuse infiltrative type, differentiation of pathological tissue, degree of invasion and metastasis, difference with PINand prostatic hyperplasia, and so on. Immunohistochemical staining was used to study and compare the expression of K-ras-EGFRMMP2 and MMP9 protein in the tissues of prostate cancer with different types of ultrasound. Results in 30 cases of simple nodular carcinoma, 4 cases of poorly differentiated adenocarcinoma, 0 cases of metastasis, 20 cases of nodular infiltrative carcinoma, 14 cases of poorly differentiated adenocarcinoma, 15 cases of metastasis, 24 cases of diffuse infiltrative carcinoma and 20 cases of poorly differentiated adenocarcinoma. There were 19 cases of metastasis. The proportion of poorly differentiated adenocarcinoma and infiltrating metastatic stage C D in nodular infiltrating type and diffuse infiltrating type of prostate cancer was significantly higher than that in simple nodular carcinoma (P < 0.05), but there was no significant difference between the former two types (P > 0.05). The positive rate of K-ras protein expression and strong positive rate of K-ras protein and positive rate of EGFR protein expression in PIN group were significantly higher than those in hyperplasia group (P < 0.05), the positive rate and strong positive rate of K-ras protein expression and EGFR in nodular infiltrating type and diffuse infiltrating type of prostate cancer were significantly higher than those in proliferative group (P < 0.05). The positive rate of protein expression was significantly higher than that of simple nodular type and PIN group (P < 0.05), but the positive rate of K-ras protein expression and strong positive rate of EGFR protein expression in simple nodular type prostate cancer was not significantly different from that of PIN group (P > 0.05), and the nodule infiltrating type and Mian group had no significant difference compared with PIN group (P > 0.05). There was no significant difference in the positive rate of K-ras protein expression, strong positive rate and EGFR protein expression in diffuse invasive prostate cancer (P > 0.05). 3 positive rates of MMP2 protein expression, MMP9 protein expression and strong positive positive rate of MMP9 protein in three types of prostate cancer and PIN group were not significantly different (P > 0.05). The positive rate of MMP2 protein, MMP9 protein expression and strong positive rate in nodular infiltrating type and diffuse infiltrating type of prostate cancer were significantly higher than those of simple nodular type and PIN group (P < 0.05), and the positive rate of MMP2 protein and MMP9 protein expression in nodular type and diffuse infiltrating type of prostate cancer were significantly higher than those in simple nodular type and PIN group (P < 0.05). The positive rate of MMP2 protein expression, MMP9 protein expression and strong positive rate of prostate cancer were not significantly different from those of PIN group (P > 0.05), the positive rate of MMP2 protein expression, MMP9 protein expression and strong positive rate of nodular infiltrating type and diffuse infiltrating type prostate cancer were not significantly different from those of PIN group (P > 0.05). There was no significant difference in the positive rates between the two groups (P > 0.05). Conclusion: during the development of prostate cancer, Simple nodular prostate cancer has high differentiation and no distant metastasis, its malignancy is low, and its tissue characteristics are close to PIN nodules, so it can be considered to follow up and wait for treatment. The degree of differentiation between nodular infiltrating prostate cancer and diffuse infiltrating prostate cancer is low, and it is easy to metastasize far away, and its malignant degree is higher. Therefore, it is suggested that surgical treatment should be carried out as soon as possible.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R737.25

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