ER、PR、WT-1、Ki-67、CA125在卵巢浆液性癌中的表达及临床意义

发布时间：2018-04-24 17:53

本文选题：浆液性卵巢癌 + 免疫组化　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:分析卵巢浆液性癌中ER、PR、WT-1、Ki-67、CA125的表达情况,分析新辅助化疗是否对卵巢癌组织中此类蛋白的表达产生影响;ER、PR、WT-1、Ki-67、CA125与发病年龄、是否绝经、肿瘤的分型、病理分期、淋巴转移、腹水、残余肿瘤体积等情况进行比较,为卵巢浆液性癌的临床诊断、预后分析及激素治疗提供参考。方法:筛选2014年1月至2015年12月在吉林大学第一医院妇产科初治的卵巢浆液性癌患者82例,收集患者的病理学参数(年龄、临床分期、组织分化、组织类型等),根据我院病理科医生所检测的ER、PR、WT-1、Ki-67、CA125的结果,分析其中相关关系。采用SPSS 21.0统计学软件对数据进行处理,用χ2检验、Fisher确切概率分析法对数据进行率的检验,相关性检验采用Spearman等级相关检验进行分析,检验水准p0.05为无统计学差异,p0.05有统计学意义,p0.01为统计学差异非常显著。结果:1、卵巢浆液性癌中,ER、PR、WT-1、Ki-67、CA125均有表达,其表达率分别为:76.83%、47.56%、85.37%、90.24%和90.24%。2、ER表达情况与FIGO分期、有无腹水之间存在显著差异(p0.05),且在Ⅲ、Ⅳ期卵巢浆液性癌中的表达明显高于I、II期,有腹水组高于无腹水组。3、PR的表达在是否绝经组存在差异(P0.05),其余组p值均0.05,在绝经组PR表达明显高于非绝经组。4、WT-1表达情况在各组临床病理指标间,除FIGO分期(p0.05)外均无显著性差异,WT-1的表达率在Ⅲ、Ⅳ组明显多于I、II期组。5、Ki-67的表达在组织分化组、FIGO分期组存在差异(p0.05),其中高级别组明显多于低级别组,Ⅲ、Ⅳ期卵巢浆液性癌明显多于I、II期。6、CA125的表达在FIGO分期组、有无腹水组和病灶残留组有显著性差异(p0.05),Ⅲ、Ⅳ期卵巢浆液性癌明显多于I、II期,有腹水组高于无腹水组,病灶残留≥1cm组多余病灶1cm组。7、ER、PR、WT-1、Ki-67、CA125之间,ER与PR、ER与WT-1、WT-1与CA125、Ki-67与CA125之间有相关性(p0.05),且均为正相关,其他各因素间不具有相关性。结论:1、卵巢浆液性癌中,ER、PR、WT-1、Ki-67、CA125均有表达,其表达率分别为:76.83%、47.56%、85.37%、90.24%和90.24%,为卵巢浆液性癌的靶向治疗及内分泌治疗提供理论依据。2、WT-1在晚期的卵巢浆液性癌患者中多呈阳性表达,且与临床分期之间密切相关,这可能因为WT-1在肿瘤细胞起着激活作用,为卵巢癌的靶向基因治疗提供依据。3、Ki-67在卵巢浆液性癌中,与组织分化组、FIGO分期组存在显著差异,CA125在FIGO分期组、有无腹水组和病灶残留组间有显著性差异,本文虽未行生存期相关检查,但根据上述病理学参数与生存期关系可知,二者高表达时可能提示预后不良。4、ER的表达与FIGO分期、有无腹水之间存在显著差异,PR在是否绝经组间存在差异,ER、PR之间存在正相关,提示二者可能共同作用于卵巢浆液性癌,为后续卵巢癌患者的内分泌治疗提供参考。5、ER与WT-1的表达之间存在正相关,可能共同参与了卵巢癌的发生发展过程,但是其间作用机制还需要后续研究进一步明确。6、CA125与WT-1、CA125与Ki-67的表达之间具有相关性,且为正相关,所以在卵巢癌的判定过程中联合CA125、WT-1和Ki-67可能提高检测的准确性。
[Abstract]:Objective: to analyze the expression of ER, PR, WT-1, Ki-67 and CA125 in ovarian serous carcinoma, and to analyze the effect of neoadjuvant chemotherapy on the expression of such proteins in ovarian cancer; ER, PR, WT-1, Ki-67, CA125 and age, menopause, pathological stage, lymphatic metastasis, ascites, and residual tumor volume, are compared. The clinical diagnosis, prognosis analysis and hormone therapy of ovarian serous carcinoma provide reference. Methods: 82 cases of ovarian serous cancer were selected from January 2014 to December 2015 in No.1 Hospital of Jilin University of gynecology and obstetrics, and collected the pathological parameters of the patients (age, clinical stage, group differentiation, tissue type, etc.), according to the doctor of pathology of our hospital. The results of ER, PR, WT-1, Ki-67, CA125 were detected. The data were processed by SPSS 21 statistical software, the data rate was tested by the x 2 test, the exact probability analysis of Fisher was tested, the correlation test was analyzed with Spearman grade correlation test, and the test level P0.05 was not statistically different, and P0.05 had statistics. The significance of P0.01 was statistically significant. Results: 1, in ovarian serous carcinoma, ER, PR, WT-1, Ki-67, CA125 were expressed, and their expression rates were 76.83%, 47.56%, 85.37%, 90.24% and 90.24%.2 respectively. There was a significant difference between the expression of ER and the stage of FIGO (P0.05), and the expression of the ovarian serous carcinoma in stage III and IV was obviously expressed. Higher than I, II, and ascites group was higher than no ascites group.3, the expression of PR in the menopause group was different (P0.05), the other group P value was 0.05, the expression of PR in the menopause group was significantly higher than the non menopause.4, the WT-1 expression in each group of clinicopathological indexes, except FIGO stages (P0.05), there were no significant differences, WT-1 expression rate in the third, group IV obviously more than those in the group. The expression of.5 and Ki-67 in the II group was in the tissue differentiation group and the FIGO staging group was different (P0.05). The advanced group was obviously more than the low grade group. The ovarian serous carcinoma in stage III and IV was obviously more than I, II stage.6 and CA125 expressed in the FIGO staging group. There was significant difference between the ascites group and the residual focus group (P0.05), and the ovarian serous carcinoma in stage III and IV was significantly more. At I and II, the group of ascites was higher than that in the non ascites group, and the residual lesion of the lesion was more than 1cm in group 1cm.7, ER, PR, WT-1, CA125, ER and PR. The expression rate is 76.83%, 47.56%, 85.37%, 90.24% and 90.24%, which provide a theoretical basis for the targeting and endocrine therapy of ovarian serous carcinoma,.2. WT-1 is mostly positive in patients with advanced ovarian serous carcinoma and is closely related to clinical stages, which may be due to the activation of WT-1 in the tumor cells. The target gene therapy of nested carcinoma provides a basis for.3, and there is a significant difference between Ki-67 in ovarian serous carcinoma, tissue differentiation group and FIGO staging group. There are significant differences between CA125 in FIGO staging group, and there is a significant difference between the group of ascites and the residual focus group. This article has not checked the survival time, but the two groups are based on the relationship between the above pathological parameters and the survival time. High expression may indicate poor prognosis.4, ER expression and FIGO staging, there is a significant difference between ascites and non ascites. There is a difference between PR in the menopause group and there is a positive correlation between ER and PR, suggesting that the two may work together in the ovarian serous carcinoma, providing a reference.5 for the endocrine therapy of the subsequent ovarian cancer patients, and between the expression of ER and WT-1. There is a positive correlation, which may be involved in the development of ovarian cancer, but the mechanism of action also needs further research to further clarify.6, CA125 and WT-1, and the correlation between CA125 and Ki-67, and it is positive correlation, so the combination of CA125, WT-1 and Ki-67 in the determination of ovarian cancer may improve the accuracy of the detection.

【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】：R737.31

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