中介体复合物19（MED19）在人舌癌中的表达及预后分析

发布时间：2018-07-02 08:44

本文选题：中介体复合物19 + 舌癌　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:口腔颌面部的恶性肿瘤多属于鳞状细胞癌,其发病占颌面部恶性肿瘤的80%以上,而舌体是其高发部位。在我国多见于成年男性患者,早期常有淋巴结转移,晚期可向远处转移。目前没有特异性强的舌癌诊断指标。研究表明,在多种人类肿瘤中都能够发现MED19的高表达,并且在体外实验发现抑制MED19能够引起相应肿瘤细胞系的生长抑制和凋亡增加。本实验探讨MED19在舌癌中的表达,研究其与患者的临床特征的相关性,并与患者预后生存率进行相关分析。方法:收集2012年1月至2016年9月,青岛大学附属烟台毓璜顶医院病理科舌癌标本蜡块50例,全部患者均临床资料完整,无其他恶性肿瘤并发且术前无放化疗史。另外选择50例癌旁组织和20例正常组织作为对照组。癌旁组织取自距癌组织1cm处。于距离癌组织大于1cm处取癌旁组织。整理了2012年1月至2014年6月,青岛大学附属烟台毓璜顶医院口腔颌面外科24例舌癌患者。通过复查或电话随访获取资料。应用单因素和多因素COX回归分析MED19与患者预后的相关性,通过Kaplan-Meier分析MED19与患者生存率的关系。结果:免疫组化实验显示,MED19在舌癌细胞的细胞核与细胞浆中都有高表达,染色棕黄。MED19在50例TSCC组织中有29例表达,阳性率为58%,MED19在癌旁表达率较低,50例癌旁仅有11例表达,阳性率为22%,在20例正常口腔组织中有4例表达,阳性率为20%,差异有统计学意义(P0.05)。MED19蛋白在有淋巴结转移组的阳性表达率为88.2%,在无淋巴结转移组的阳性率为42.4%,差异明显,且具有统计学意义(P0.05)。MED19蛋白的表达与患者TNM分期相关(P0.05),与性别、年龄、肿瘤大小、分化程度之间无统计学意义(P0.05)。单因素COX分析发现,肿瘤的分期、复发情况和MED19蛋白表达与患者预后相关(P0.05),多因素COX分析发现复发情况和MED19蛋白的表达与患者预后相关(P0.05)。单因素和多因素COX分析肿瘤复发情况和MED19的表达与患者预后相关,而患者性别、年龄、肿瘤大小、肿瘤分期和分化与患者预后情况无关(P0.05)。生存分析显示MED19高表达组生存率明显低于MED19低表达组。结论:实验显示MED19蛋白表达与舌癌发生有关。分析结果提示MED19蛋白表达与舌癌患者淋巴结转移和TNM分期有关,与年龄、性别及分化程度均无关。单因素和多因素COX分析肿瘤复发情况和MED19的表达与患者预后相关。生存分析提示MED19高表达组患者总体生存率较MED19低表达组明显较低。
[Abstract]:Objective: most malignant tumors in oral and maxillofacial region belong to squamous cell carcinoma (SCC), which accounts for more than 80% of malignant tumors in maxillofacial region. In our country, it is more common in adult male patients, lymph node metastasis often occurs in the early stage and distant metastasis in the late stage. There is no specific diagnostic index for tongue cancer. Studies have shown that high expression of MED19 can be found in a variety of human tumors, and in vitro, inhibition of MED19 can induce growth inhibition and apoptosis increase in the corresponding tumor cell lines. This study was designed to investigate the expression of MED19 in tongue cancer, and to study the correlation between MED19 and clinical features, and the prognostic survival rate. Methods: from January 2012 to September 2016, 50 cases of tongue cancer specimens from the Department of Pathology of Yantai Yuzhouding Hospital, affiliated to Qingdao University, were collected. All the patients had complete clinical data, no other malignant tumors and no history of radiotherapy and chemotherapy before operation. In addition, 50 paracancerous tissues and 20 normal tissues were selected as control group. The paracancerous tissue was taken from 1cm. The paracancerous tissue was removed from the cancer tissue longer than the 1cm. From January 2012 to June 2014, 24 patients with tongue cancer in the Department of Oral and Maxillofacial surgery, Yantai Yuzhouding Hospital, Qingdao University were reviewed. Data were obtained by review or telephone follow-up. Univariate and multivariate Cox regression analysis was used to analyze the correlation between MED19 and prognosis. Kaplan-Meier was used to analyze the relationship between MED19 and survival rate. Results: the expression of MED19 was high in the nuclei and cytoplasm of tongue cancer cells, and 29 cases were stained brown and yellow in 50 cases of TSCC. The positive rate of MED19 expression was 58%. The expression rate of MED19 was lower in 50 cases than that in the adjacent tissues of 50 cases. The positive rate of MED19 protein was 88.2in the group with lymph node metastasis, and the positive rate of MED19 protein in the group without lymph node metastasis was 42.4% (P < 0.05), and the positive rate of MED19 protein in the group without lymph node metastasis was 42.4% (P < 0.05), and the positive rate of MED19 protein in the group without lymph node metastasis was 42.4% (P < 0.05). The expression of MED19 protein was correlated with TNM stage (P0.05), but not between sex, age, tumor size and differentiation (P0.05). Univariate Cox analysis showed that tumor staging, recurrence and MED19 protein expression were correlated with the prognosis (P0.05), multivariate Cox analysis found that recurrence and MED19 protein expression were related to the prognosis of patients (P0.05). Univariate and multivariate Cox analysis showed that tumor recurrence and MED19 expression were correlated with prognosis, but gender, age, tumor size, tumor stage and differentiation were not correlated with prognosis (P0.05). Survival analysis showed that the survival rate of MED 19 high expression group was significantly lower than that of MED 19 low expression group. Conclusion: MED 19 protein expression is associated with tongue cancer. The results suggested that the expression of MED19 protein was correlated with lymph node metastasis and TNM stage, but not with age, sex and differentiation. Univariate and multivariate Cox analysis of tumor recurrence and MED 19 expression were associated with prognosis. Survival analysis showed that the overall survival rate of patients with high MED 19 expression was significantly lower than that of MED 19 patients with low MED 19 expression.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.86

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