口腔肿瘤组织HPV感染和p16蛋白表达及其意义

发布时间：2018-05-17 01:34

本文选题：口腔肿瘤 + 人乳头状瘤病毒　；参考：《蚌埠医学院》2017年硕士论文

【摘要】：背景:近年来大量研究表明,与HPV阴性相比,HPV阳性口腔肿瘤患者肿瘤进展的风险较低,肿瘤生长速度慢、恶化机率低,对放化疗治疗更为敏感,预后明显好于HPV阴性的口腔肿瘤患者,提示人乳头状病毒(HPV)在口腔肿瘤的发生发展中起重要作用。但目前关于口腔肿瘤中HPV的感染率,文献报道的差异很大,对口腔肿瘤与HPV感染相关性的病因学探讨不多,其具体致病机制尚不清楚。另外,有研究报道,p16抑癌基因的产物p16蛋白的表达与HPV感染密切相关,并有研究者建议可作为HPV的替代检测手段。皖北地区是口腔肿瘤的多发地区之一,本地区口腔肿瘤中HPV的感染率如何?p16蛋白在口腔肿瘤组织的表达如何?HPV感染和p16蛋白表达相关性如何?这些均未见报道,有待阐明。目的:检测口腔肿瘤组织HPV感染率和p16蛋白表达情况,并探讨两者在口腔肿瘤中的相关性。方法:收集2014年10月~2015年10月蚌埠医学院第一附属医院口腔科初治的口腔肿瘤患者的肿瘤新鲜组织44例,并记录患者的年龄、性别、吸烟、饮酒等基本病例情况,同时收集该医院口腔部非肿瘤患者组织20例(包括口腔部外伤或鼾症矫形手术、炎症、囊肿)用作对照组。采用PCR法检测肿瘤组织和非肿瘤组织内HPV DNA的表达,了解口腔肿瘤组织中HPV感染情况;应用免疫组织化学染色法检测肿瘤组织和非肿瘤组织中p16蛋白表达情况;分析HPV感染与p16蛋白表达之间的相关性及其两者分别在鉴别口腔肿瘤和非肿瘤中的意义。结果:口腔肿瘤组织及非肿瘤组织中HPV感染率分别为47.7%(21/44)和10%(2/20)、p16蛋白阳性率分别为77.3%(34/44)和0%(0/20);HPV感染与p16蛋白表达无相关性(P0.05);口腔肿瘤组织中,与HPV阴性组相比,HPV阳性组男性、非抽烟、非嗜酒者所占比例较高,分别是66.7%vs 66.5%,71.4%vs62.5%,76.2%vs 73.9%,但无统计学意义(P0.05);与p16蛋白阴性组相比,p16阳性组男性、非抽烟、非嗜酒者所占比例也较高,分别是67.6%vs 60%,94.1%vs 80%,76.4%vs 70%,也无统计学意义(P0.05)。结论:皖北地区口腔肿瘤与HPV感染密切相关;口腔肿瘤组织p16蛋白表达阳性率较高,但与HPV感染无相关性,p16免疫组化不能作为口腔肿瘤患者HPV感染检测的替代检测手段;p16蛋白阳性的口腔肿瘤可能是一个独立的亚型;HPV感染和p16蛋白表达与性别、吸烟、嗜酒无关。
[Abstract]:Background: in recent years, a large number of studies have shown that compared with HPV negative, the risk of tumor progression in patients with HPV positive oral tumor is lower, the growth rate of tumor is slow, the probability of deterioration is low, the treatment is more sensitive to radiotherapy and chemotherapy, and the prognosis is better than that of HPV negative oral cancer patients, which suggests that the human breast cancer virus (HPV) plays an important role in the development of oral tumor. But at present, the rate of HPV infection in oral tumor is very different. The etiology of oral tumor and HPV infection is not much, and its specific pathogenesis is not clear. In addition, there are research reports that the expression of p16 protein of the product of p16 suppressor gene is closely related to HPV infection, and some researchers suggest that it can be used as HPV. What is the infection rate of HPV in oral tumor in the local area? How is the expression of p16 protein in oral tumor tissue? How is the correlation between HPV infection and p16 protein expression? These have not been reported and need to be clarified. Objective: to detect the HPV infection rate and the p16 protein table in oral tumor tissue Methods: 44 cases of tumor fresh tissue in oral cancer patients in Department of Stomatology, the First Affiliated Hospital of Bengbu Medical College, October 2014, October ~2015, were collected. The age, sex, smoking, drinking and other basic cases of the patients were recorded, and the non tumor patients in the hospital oral cavity were collected. 20 cases (including oral trauma or snoring orthopedic surgery, inflammation, cysts) were used as control group. The expression of HPV DNA in tumor tissues and non tumor tissues was detected by PCR, and HPV infection in oral tumor tissues was detected. The expression of p16 protein in swelling and non tumor tissues was detected by immunohistochemical staining. The correlation between HPV infection and the expression of p16 protein and the significance of the two were respectively in the identification of oral tumor and non tumor. Results: the infection rate of HPV in oral tumor tissues and non tumor tissues was 47.7% (21/44) and 10% (2/20), and the positive rates of p16 protein were 77.3% (34/44) and 0% (0/20), respectively; HPV infection and p16 protein expression were not correlated (P0.05). In the oral tumor tissue, compared with the HPV negative group, the proportion of non smoking and non alcoholic people in the HPV positive group was higher, which was 66.7%vs 66.5%, 71.4%vs62.5%, 76.2%vs 73.9%, but no statistical significance (P0.05). Compared with the p16 protein negative group, the percentage of non smoking and non alcoholic persons in the p16 positive group was also higher, respectively, 67.6%vs 60%, 94.1, respectively. %vs 80%, 76.4%vs 70%, and no statistical significance (P0.05). Conclusion: the oral tumor in Northern Anhui is closely related to HPV infection; the positive rate of p16 protein expression in oral tumor tissues is high, but it has no correlation with HPV infection. P16 immunohistochemistry can not be used as a substitute for the detection of HPV infection in oral cancer patients; the p16 protein positive oral tumor can be found. It can be an independent subtype; HPV infection and p16 protein expression are not related to sex, smoking and alcohol consumption.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.8;R730.43

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