β-微管蛋白及M2型丙酮酸激酶在卵巢癌诊断中的意义

发布时间：2018-12-18 21:19

【摘要】：目的：目前卵巢癌的主要标志物为CA-125，但在卵巢癌早期其敏感性及特异性都不高。如在结核性胸膜炎、结核性腹膜炎、肾病综合征并发腹水者，其CA-125均可升高。本实验通过免疫组化方法比较卵巢浆液性囊腺瘤和卵巢浆液性囊腺癌组织中β-微管蛋白及M2型丙酮酸激酶的表达情况，进一步验证这两种蛋白在卵巢癌组织中高表达。两种肿瘤标记物有机结合，有利于提高卵巢癌早期诊断的敏感性与特异性。方法：取吉林大学第二医院2009年8月—2012年11月间的石蜡包埋组织标本，其中卵巢浆液性囊腺癌40例，卵巢浆液性囊腺瘤40例。采用S-P免疫组织化学法进行染色，，采用Tanaka的定量计分法计算染色结果。以SPASS17.0统计学软件进行分析，P＜0.05提示差异有统计学意义。结果： 1.β-微管蛋白在卵巢浆液性囊腺癌中阳性表达36例，阳性率90%；在卵巢浆液性囊腺瘤组织中阳性表达8例，阳性率20%；这种表达差异是有统计学意义的(χ2=39.596，P=0.000)。 2.PKM2卵巢浆液性囊腺癌中阳性表达35例，阳性率87.5%；在卵巢浆液性囊腺瘤组织中阳性表达17例，阳性率42.5%；这种表达差异亦有统计学意义(χ2=17.802，P=0.000)。 3.β-微管蛋白的阳性率在卵巢浆液性囊腺癌组内，即I、II、III期中分别为75.0%，83.3%，93.3%，差异无统计学意义(P0.05)； 4.PKM2的阳性率在卵巢浆液性囊腺癌组内，即I、II、III期中分别为75.0%，83.3%，90.0%，差异无统计学意义(P0.05)； 5.依据Tanaka的计分法，染色阳性程度可分为3个级别，β-微管蛋白的阳性级别与肿瘤分期无明显相关性(P0.05)。 6.依据Tanaka的计分法，染色阳性程度可分为3个级别，PKM2的阳性级别与肿瘤分期无明显相关性(P0.05)。 7.在浆液性卵巢癌组织中，β-微管蛋白与PKM2的阳性率结果无明显相关性。结论：本实验进一步证明β-微管蛋白、PKM2卵巢浆液性囊腺瘤组织中低表达，在卵巢浆液性囊腺癌组织中高表达，且其在早期卵巢浆液性囊腺癌中的表达与晚期无明显差异。这为寻求卵巢癌早期诊断新指标提供了新思路。
[Abstract]:Objective: at present, the main marker of ovarian cancer is CA-125, but its sensitivity and specificity are not high in early stage of ovarian cancer. As in tuberculous pleurisy, tuberculous peritonitis, nephrotic syndrome complicated with ascites, their CA-125 can be increased. The expression of 尾 -tubulin and type M2 pyruvate kinase in ovarian serous cystadenoma and ovarian serous cystadenocarcinoma was compared by immunohistochemical method. The combination of two tumor markers can improve the sensitivity and specificity of early diagnosis of ovarian cancer. Methods: paraffin embedded tissue samples were collected from the second Hospital of Jilin University from August 2009 to November 2012. 40 cases of ovarian serous cystadenocarcinoma and 40 cases of ovarian serous cystadenoma were collected. S-P immunohistochemical method was used for staining and Tanaka's quantitative scoring method was used to calculate the staining results. The results were analyzed by SPASS17.0 software, and the difference was statistically significant (P < 0. 05). Results: 1. Positive expression of 尾 -tubulin in ovarian serous cystadenocarcinoma was found in 36 cases (90%), and in ovarian serous cystadenoma in 8 cases (20%). The difference of this expression was statistically significant (蠂 2 / 39.596 P = 0.000). 35 cases (87.5%) were positive in 2.PKM2 ovarian serous cystadenocarcinoma and 17 cases (42.5%) in ovarian serous cystadenoma. 3. The positive rate of 尾 -tubulin in ovarian serous cystadenocarcinoma group was 75.0 and 83.3%, respectively (P0.05). The positive rate of 4.PKM2 in ovarian serous cystadenocarcinoma group was 75.0%, 83.3% and 90.0%, respectively. The difference was not significant (P0.05). According to the Tanaka scoring method, the staining positive degree can be divided into three grades, the positive grade of 尾 -tubulin has no significant correlation with the tumor stage (P0.05). 6. According to the Tanaka scoring method, the staining positive degree can be divided into three grades, the positive grade of PKM2 has no significant correlation with the tumor stage (P0.05). 7. There was no significant correlation between 尾-tubulin and PKM2 positive rate in serous ovarian carcinoma. Conclusion: this study further demonstrated the low expression of 尾-tubulin and PKM2 in ovarian serous cystadenoma, and the high expression of 尾-tubulin in ovarian serous cystadenocarcinoma. There was no significant difference between early ovarian serous cystadenocarcinoma and late stage. This provides a new idea for early diagnosis of ovarian cancer.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.31

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