早期宫颈鳞癌患者预后相关因素的研究

发布时间：2018-02-12 08:26

本文关键词： 宫颈癌 HLA-G 淋巴细胞计数预后　出处：《中国人民解放军医学院》2014年硕士论文　论文类型：学位论文

【摘要】：第一部分人类白细胞抗原G在宫颈癌组织中的表达与预后的关系目的：探讨人类白细胞抗原G（HLA-G）在宫颈癌组织中的表达及其对患者预后。方法：应用免疫组织化学方法（S-P法）检测2006年1月—2012年12月就诊我院98例IB--IIA期宫颈鳞癌组织中HLA-G蛋白的表达，并分析HLA-G的表达与临床病理参数、患者预后之间的关系。结果：HLA-G分子在宫颈癌组织中表达率为43.9%（43/98），而癌旁正常宫颈组织的表达率为0（0/20）。HLA-G分子表达与分化程度、淋巴结转移、脉管浸润具有相关性（P＜0.05）。HLA-G表达阳性的早期宫颈癌患者无瘤生存期、总生存期均显著低于HLA-G阴性患者（P=0.029；P=0.024）。结论：HLA-G分子在宫颈癌组织中表达上调，，并与宫颈癌的生物学侵袭行为相关，促进肿瘤的发生、发展，影响患者预后。第二部分早期宫颈癌患者围手术期淋巴细胞计数与预后之间的关系目的：探讨早期宫颈癌患者围手术期外周血淋巴细胞计数变化与其预后的关系。方法：回顾性分析2006年1月至2012年12年就诊于解放军总医院，根据2009年最新宫颈癌FIGO指南诊断为IB～IIA期宫颈癌患者的临床病历资料，分为腹腔镜组和开腹组。比较两组患者手术基本情况（手术时间、术中出血量、输血率、淋巴结个数），分析患者的围手术期淋巴细胞数和其无瘤生存期、总生存期间的关系。结果：共222例早期宫颈癌患者纳入研究，腹腔镜组106例，开腹组116例。随访时间为6～89个月，中位随访时间为53个月。宫颈癌患者术前淋巴细胞计数增高，其无瘤生存期、总生存期均显著延长；腹腔镜组术后第一天淋巴细胞数下降程度较开腹组明显减小（P＜0.05），同时，腹腔镜组患者术后第三天淋巴细胞数上升也较开腹组迅速（P＜0.05）。患者术后第三天淋巴细胞计数高于或恢复至术前水平，无瘤生存期显著延长（P＜0.05）。结论：术前淋巴细胞数和术后第三天淋巴细胞数的变化均可作为评估宫颈癌术后患者预后的重要参考指标。
[Abstract]:The relationship between the expression of Human Leukocyte Antigen G and prognosis in Cervical carcinoma. Objective: to investigate the expression of human leukocyte antigen GG in cervical carcinoma and its prognostic significance. Methods: the expression of HLA-G protein in 98 cases of cervical squamous cell carcinoma (IB--IIA) from January 2006 to December 2012 was detected by immunohistochemical method. The relationship between the expression of HLA-G and clinicopathological parameters and prognosis was analyzed. Results the expression rate of HLA-G molecule in cervical cancer was 43.9% / 98%, while that in normal cervical tissues adjacent to carcinoma was 0% 20%. The expression and differentiation of HLA-G molecule, lymph node metastasis and vascular infiltration were correlated to the tumor-free survival time of early cervical cancer patients with positive expression of HLA-G (P < 0.05). The total survival time was significantly lower than that in HLA-G negative patients. Conclusion the expression of HLA-G in cervical carcinoma is up-regulated, which is related to the biological invasion behavior of cervical cancer, which promotes the development of tumor and affects the prognosis of cervical cancer. The relationship between perioperative lymphocyte count and prognosis in patients with early cervical cancer. Objective: to investigate the relationship between peripheral blood lymphocyte count and prognosis of early cervical cancer patients. Methods: the clinical data of patients with stage IB~IIA cervical cancer diagnosed by the latest cervical cancer FIGO guidelines of 2009 were retrospectively analyzed in General Hospital of PLA from January 2006 to 2012. The patients were divided into laparoscopy group and laparotomy group. The operation time, intraoperative blood loss, blood transfusion rate and lymph node number were compared between the two groups, and the relationship between the number of lymphocytes in perioperative period and their tumor-free survival time and total survival period were analyzed. Results: a total of 222 patients with early cervical cancer were included in the study. There were 106 cases in the laparoscopic group and 116 cases in the open group. The follow-up time was 6 ~ 89 months and the median follow-up time was 53 months. The total survival time was significantly prolonged in the laparoscopy group, the first day after operation, the decrease of lymphocyte number in the laparoscopy group was significantly lower than that in the open group (P < 0.05), and at the same time, On the third day after operation, the lymphocyte count in the laparoscopic group was also increased more rapidly than that in the open group (P < 0.05), and the lymphocyte count was higher or returned to the preoperative level on the third day after operation, and the tumor-free survival time was significantly prolonged (P < 0.05). Conclusion: the change of lymphocyte number before operation and on the third day after operation can be used as an important index to evaluate the prognosis of patients with cervical cancer after operation.
【学位授予单位】：中国人民解放军医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

【参考文献】