MCM5蛋白在子宫内膜癌中的表达及临床意义

发布时间：2018-04-09 23:05

  本文选题：子宫内膜癌　切入点：子宫内膜不典型增生　出处：《承德医学院》2014年硕士论文

【摘要】：子宫内膜癌是最常见的妇科恶性肿瘤之一,它是产生于子宫内膜的一组上皮性恶性肿瘤，在其多种不同起源的肿瘤中，以子宫内膜腺体的腺癌最常见。在我国，虽然其发病率和死亡率没有统计数据更准确的描述的子宫内膜癌，但至少我们可以通过报道，了解到该病的发生率每年都在增加，而且死亡率很高。所以，有必要明确一些和子宫内膜癌发生、发展有关的问题,了解一些与肿瘤相关的组织学变化，并根据子宫内膜肿瘤细胞异常增殖，及其转移机制和对周围组织的侵袭，就可以相对准确的判断肿瘤的风险评估及预后，以及制定更有效的治疗方案，提高子宫内膜癌的疗效、改善患者生活质量。 微小染色体维持蛋白(Miniehromosome Maintenance Proteins)是一组蛋白， DNA复制与其密切相关。是二十世纪80年代Bik-kwoon tye，在突变酵母中发现，然后运用分子和生物化学的实验方法提取出来的，是一组重要的同源蛋白家族，并且它们之间关联密切。微小染色体维持蛋白（McMs）在复制准许因子，RLF)中起着重要的作用，是DNA复制的一个重要成员,它在DNA复制起始前就与染色质结合，是一个新的复制过程开始的标志。RLF这个复合物是DNA复制的一个“通行证”，在真核细胞的DNA复制过程中有着无可替代的重要性。在真核细胞DNA复制过程中，MCM蛋白是这个过程中重要的调节蛋白，而DNA复制的异常调节又导致了细胞异常增殖。MCM蛋白在静止期或分化较好的细胞中很少表达或不表达，而在增殖细胞中高水平表达。由此可见MCM蛋白可以成为一种增殖细胞的特异性标志物。而MCM5是MCM蛋白家族中的六个成员之一,也就是说，检测MCM5的表达就可间接了解MCM蛋白的表达水平。因此，MCM5蛋白肿瘤研究过程中，结合患者临床资料，证实其与恶性肿瘤的病理分期、淋巴转移及预后评估有相关性，成为有价值的标记物。 本课题通过对手术切除的子宫内膜癌标本进行检测，运用免疫组化方法，了解MCM5蛋白在子宫内膜癌组织中的表达，并将其与MCM5在不典型增生的内膜组织及正常子宫内膜组织进行比较，并结合患者临床资料，分析MCM5蛋白在子宫内膜癌发生发展中的表达特点，从而为子宫内膜癌恶性程度判断和子宫内膜癌的预后评估提供新的新的肿瘤标记物。 目的: 通过对子宫内膜癌标本进行免疫组织化学染色方法，检测子宫内膜癌中MCM5蛋白的表达，与不典型增生子宫内膜组织、正常子宫内膜组织进行对比，并同时结合患者临床资料，分析MCM5蛋白在子宫内膜癌的发生发展中，其表达的特点，从而为判断子宫内膜癌恶性程度及其预后评估提供新的方法。 方法: 选取保定市二医院、承德医学院附属医院，经手术切除标本，并且所有标本经病理证实为子宫内膜癌70例（通过2年的术后随访，其中复发患者29例,同期对照无复发患者有41例）。70例癌的组织学类型均为子宫内膜样腺癌，无透明细胞癌、浆液性癌等特殊组织学类型肿瘤。所有患者术前均未经任何其他特殊治疗，例如化疗、放疗及药物，记录患者姓名、年龄、病理分期（根据2009年FIGO分期）、肿瘤分化程度，免疫组化结果、有无淋巴结转移等临床资料，另选择正常子宫内膜组织标本15例和同期不典型增生组织21例作为对照。采用免疫组织化学S-P法检测所选标本中MCM5蛋白的表达。应用统计学软件SPSS for windows14.0，通过等级资料的秩和检验和χ2检验分析，MCM5蛋白与子宫内膜腺癌的关系。 结果： 1.应用免疫组化S-P法检测子宫内膜癌组织、不典型增生子宫内膜组织、正常子宫内膜组织中MCM5蛋白的表达情况：子宫内膜癌和不典型增生子宫内膜中总阳性表达率比较无显著差异（P0.05），但在强阳性表达率的比较中，二者的差异有统计学意义（P0.05）。 2.子宫内膜癌、不典型增生子宫内膜中MCM5的表达比正常子宫内膜更广泛，且具有显著性差异（P0.05）。 结论: 1. MCM5蛋白在子宫内膜癌组织中是否高度表达，与肿瘤的分化程度、分期、是否有淋巴结转移密切相关，MCM5在不典型增生子宫内膜组织中表达也明显高于正常组织。 2. MCM5蛋白在子宫内膜癌组织中高度表达，，且与子宫内膜癌的预后评估相关。
[Abstract]:Endometrial carcinoma is one of the most common gynecologic malignant tumor, it is a group produced in the endometrial epithelial malignant tumors, in the different origin of tumors, endometrial gland carcinoma is the most common. In our country, although the incidence and mortality of no statistical data of endometrial cancer more accurately the description, but at least we can understand to the annual report, the incidence of the disease is increasing, but the mortality rate is very high. So, it is necessary to clarify some and endometrial cancer occurrence and development related issues, learn to understand the changes and some tumor related organizations, and according to the abnormal proliferation of endometrial cancer cells, and its transfer mechanism and the surrounding tissue invasion, risk assessment and prognosis of tumors can be judged to be relatively accurate, and develop more effective treatment options, improve the curative effect of endometrial carcinoma and to improve the lives of patients Quality.
Minichromosome maintenance proteins (Miniehromosome Maintenance Proteins) is a group of proteins, DNA replication is closely related. In twentieth Century 80s Bik-kwoon tye, found that mutations in yeast, and then use the experimental method of molecular and biochemical extraction, is an important group of homologous protein family, and they are closely related. Minichromosome maintenance protein (McMs) on the replication licensing factor, RLF) plays an important role, is an important member of DNA replication, it is combined with the chromatin in the initiation of DNA replication, is a new replication marks the beginning of the.RLF complex is a "pass" DNA replication, a the irreplaceable importance in the replication of eukaryotic cells. In the process of DNA replication in eukaryotic cells DNA, MCM protein is an important regulator of this process, and the abnormal regulation of DNA replication and guide Due to the abnormal proliferation of cells.MCM protein in quiescent cell differentiation or better in little or no expression, and high expression levels in proliferating cells. Thus MCM protein can be a specific marker for cell proliferation. MCM5 is one of the six members of the MCM family, that is to say, the expression of the detection of MCM5 can indirectly understand the expression level of MCM protein. Therefore, MCM5 protein in tumor research, combined with the clinical data, confirmed the malignant tumors and pathological staging, lymph node metastasis and prognostic assessment of relevance, become a valuable marker.
This topic through the detection of surgical resection of endometrial cancer specimens by immunohistochemical method, expression of MCM5 protein in endometrial carcinoma, and MCM5 were compared in atypical hyperplasia of endometrium and normal endometrium, and combined with clinical data, analysis of MCM5 protein expression in the characteristics of the occurrence and development of endometrial carcinoma, which provides a new tumor marker for a new assessment of endometrial cancer prognosis judging malignant degree and endometrial cancer.
Objective:
By immunohistochemical staining of endometrial carcinoma, the expression of MCM5 protein in endometrial carcinoma, and atypical hyperplasia of endometrium and normal endometrium were compared, and at the same time combined with the clinical data, analysis of MCM5 protein in the occurrence and development of endometrial cancer, the characteristics of its expression, in order to provide a new method for evaluating the malignancy degree and prognosis of endometrial carcinoma and its prognosis.
Method:
Select the two hospital, Baoding Affiliated Hospital of Chengde Medical College, after surgical resection specimens, and all specimens were confirmed by pathology in 70 cases of endometrial carcinoma (through 2 years of follow-up, including 29 cases of postoperative recurrence in patients with concurrent control, no recurrence in 41 patients).70 cases of cancer histological types were endometrioid adenocarcinomas. No clear cell carcinoma, serous carcinoma and other special histological types of tumor. All patients without any special treatment, such as chemotherapy, radiotherapy and drug, record the patient's name, age, pathological stage (according to the 2009 FIGO staging), tumor differentiation, immunohistochemical findings, clinical data of lymph node transfer, the other normal endometrial tissue specimens and 15 patients with atypical hyperplasia in 21 cases as control. The expression of MCM5 protein in detection of selected specimens by immunohistochemical S-P method. Using statistical software SPSS for W Indows14.0, the relationship between MCM5 protein and endometrial adenocarcinoma was analyzed by rank sum test and chi 2 test.
Result锛

本文编号：1728546