肝细胞癌的CT表现与CD34、GPC-3、HSP70表达、病理分级、患者预后的相关性研究

发布时间：2018-04-19 17:09

本文选题：肝细胞癌 + 病理分级　；参考：《右江民族医学院》2017年硕士论文

【摘要】：目的:探讨肝细胞癌术前CT表现与癌组织CD34、GPC-3、HSP70蛋白表达水平、病理分级、患者预后的相关性。方法:搜集右江民族医学院附属医院2013年7月至2015年8月在我院经病理证实为肝细胞癌的患者62例,所有病例术前行CT平扫及3期增强扫描,所有患者都有完整的随访资料,随访至2016年8月1日;运用免疫组织化学法检查癌组织中CD34、GPC-3、HSP70的蛋白表达水平;通过对比患者术前CT表现与术后切除癌组织CD34、GPC-3、HSP70的蛋白表达水平、病理分级及患者的生存时间,统计分析其是否存在相关性。结果:本研究62例HCC患者中肝癌的大小、瘤内出血坏死、动脉期肿瘤血管强化与CD34的表达水平存在相关性(P0.05);肝癌的大小、动脉期肿瘤血管强化及肝癌的供血类型与GPC-3表达水平存在相关性(P0.05);不同供血类型的肝癌HSP70的表达水平存在差异(P0.05);肝癌的大小、边缘、瘤内出血坏死与其病理分化程度相关(P0.05);肝癌的病理分化程度越低,GPC-3及HSP70的表达水平越高。CT征象中表现为有侵袭转移组及病理分化较低组患者的平均生存时间明显低于无侵袭转移组及病理分化较高组(15.4月vs28.2月,24.2月vs27.2月),差异有统计学意义(P0.05);虽然边缘模糊组生存时间低于边缘清楚组(20.4月vs28.5月),瘤内有出血坏死组生存时间低于无出血坏死组(24.1月vs31月),但差异并无统计学意义。结论:肝癌的CT表现可在一定程度上反映癌组织中CD34、GPC3、HSP70的蛋白表达水平;CD34、GPC3、HSP70的蛋白表达水平可以在一定程度上反映肝癌的病理分化程度;肝癌的CT表现可以反映癌组织的病理分化程度;CT征象中表现为有侵袭转移者及病理分化较低患者的预后较差。
[Abstract]:Objective: to investigate the correlation between preoperative CT findings and expression of CD34 GPC-3 HSP70 protein, pathological grade and prognosis of hepatocellular carcinoma (HCC).Methods: from July 2013 to August 2015, 62 patients with hepatocellular carcinoma (HCC) confirmed by pathology were collected from affiliated Hospital of Youjiang Medical College for nationalities. All patients underwent plain CT scan and 3 phase enhanced CT scan before operation, and all patients had complete follow-up data.All patients were followed up until Aug. 1, 2016. The expression of CD34GPC-3HSP70 was detected by immunohistochemical method, and the expression of CD34GPC-3HSP70 was compared with that of postoperative excision of CD34GPC-3HSP70, and the pathological grade and survival time of the patients were compared.Statistical analysis of its relevance.Results: in 62 patients with HCC, there was a correlation between tumor angiogenesis and CD34 expression, the size of HCC, the size of HCC, and the size of HCC.In arterial phase, there was a correlation between vascular enhancement and the blood supply type of HCC and the expression level of GPC-3, the expression level of HSP70 in different blood supply type of HCC was different (P0.05), the size and edge of HCC, the size of HCC, the margin of HCC, the size of HCC, the size of HCC, the margin of HCC,The expression of GPC-3 and HSP70 was higher in HCC with lower degree of pathological differentiation. Ct findings showed that the mean survival time of patients with invasion and metastasis was significantly higher than that of patients with lower pathological differentiation.It was lower than that of non-invasive metastasis group and higer pathological differentiation group (15.4 vs28.2 months, 24.2 months vs27.2 month, the difference was statistically significant P 0.05), although the survival time of fuzzy margin group was lower than that of clear margin group (20.4 vs28.5 month), the survival time of tumor with hemorrhage necrosis group was lower than that of clear margin group (20.4 vs28.5 month).In the group without hemorrhage necrosis (24.1 vs31), the difference was not statistically significant.Conclusion: Ct findings of HCC can reflect the expression level of GPC3HSP70 in HCC to a certain extent. The expression level of HSP70 in CD34GPC3hSP70 can reflect the degree of pathological differentiation of HCC to some extent.Ct findings of hepatocellular carcinoma can reflect the degree of pathological differentiation of carcinoma. The prognosis of patients with invasion and metastasis and patients with poor pathological differentiation is poor.
【学位授予单位】：右江民族医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7;R730.44

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