组织因子阳性微粒在恶性实体瘤中临床意义的初步探索

发布时间：2018-05-28 06:57

本文选题：肿瘤 + 组织因子阳性微粒　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:(1)检测恶性实体瘤(malignant solid tumors)患者血浆中组织因子阳性微粒(tissue factor positive microparticles,TF+MP)的表达水平,初步探讨其在恶性实体瘤中的表达;(2)比较在恶性实体瘤不同分期中TF+MP的表达水平,探讨其是否与肿瘤进展相关;(3)比较恶性实体瘤合并血栓形成中TF+MP的表达水平,探讨TF+MP在肿瘤合并血栓形成中的作用;(4)检测恶性实体瘤在麻醉前后TF+MP表达水平,探讨麻醉因素对肿瘤患者中TF+MP的影响;(5)检测恶性实体瘤患者在手术前后中TF+MP表达水平,探讨恶性实体瘤患者手术后易发血栓形成的可能原因。方法:收集我院住院并行手术治疗的恶性实体瘤患者36例为实验组及健康体检者29例为对照组。检测恶性实体瘤患者体内TF+MP的表达水平并比较肿瘤不同分期、合并血栓形成以及麻醉前后和手术前后中TF+MP的变化情况:对照组抽取清晨空腹静脉血,实验组分别于麻醉前、麻醉后和手术后抽取空腹静脉血,两次离心处理后得到乏血小板血浆(platelet poor plasma,PPP),采取免疫荧光技术用FITC-Annexin-Ⅴ抗体和PE-TF抗体标记目的颗粒TF+MP,然后采用流式细胞仪进行检测并分析目的颗粒TF+MP:直径0.1-1.0um、FITC-Annexin-Ⅴ抗体和PE-TF抗体双标阳性。最后比较各组中TF+MP的表达情况。结果:(1)TF+MP在恶性实体肿瘤患者与健康对照组之间的整体表达水平:TF+MP在恶性实体瘤患者体内的表达比健康组中的表达升高:(25.45±16.04)%vs(11.31±6.22)%,t=3.934,P0.001,提示在恶性实体瘤患者中TF+MP高表达。(2)TF+MP在肿瘤各分期中的表达水平:在Ⅰ期肿瘤患者体内的TF+MP水平与健康组无明显差异:(15.22±12.93)%vs(11.31±6.22)%,t=1.147,P=0.261;Ⅱ-Ⅳ期肿瘤患者的TF+MP表达明显比Ⅰ期升高(P0.05),而Ⅱ期、Ⅲ期和Ⅳ期肿瘤患者之间表达的TF+MP无明显变化(P0.05):(15.22±12.93)%vs(28.89±8.24)%vs(28.03±19.38)%vs(33.60±7.85)%。提示进展期的恶性实体瘤表达的TF+MP明显增高。(3)TF+MP在恶性实体瘤合并VTE患者中的表达水平:TF+MP在恶性实体瘤合并VTE的患者的表达比未合并VTE的患者有显著升高趋势:33.0%,提示TF+MP增高在恶性实体瘤合并血栓形成患者中可能发挥了重要作用。(4)TF+MP在恶性实体瘤患者麻醉前后的表达水平:在恶性实体瘤患者麻醉前后体内TF+MP表达水平无明显变化:(25.45±16.04)%vs(24.68±15.05)%,t=0.206,P=0.838,提示麻醉因素对患者术后TF+MP的表达无显著影响。(5)TF+MP在恶性实体瘤患者手术前后的表达水平:恶性实体瘤患者手术前后比较,TF+MP的表达在术后有所增高:(24.68±15.05)%vs(32.99±17.92)%,t=2.074,P=0.042,提示手术可促进肿瘤患者体内TF+MP的释放或表达。结论:(1)TF+MP在恶性实体瘤患者中的表达高于健康对照组,且II、III、IV期明显高于I期,提示恶性实体瘤TF+MP高表达,而且随着肿瘤进展其表达水平提高,故而TF+MP高表达可能提示恶性实体瘤的发生并且反映肿瘤的进展;(2)TF+MP可能与恶性实体瘤易发血栓形成密切相关;(3)恶性实体瘤患者术后易发血栓形成可能与手术促进TF+MP的高表达有关,而麻醉因素不影响TF+MP表达,与恶性实体瘤患者术后血栓形成无关。综上所述,TF+MP可能与恶性实体瘤的发生、进展及血栓形成相关,很可能是恶性实体瘤患者手术后易发血栓的重要因素。
[Abstract]:Objective: (1) to detect the expression level of tissue factor positive particles (tissue factor positive microparticles, TF+MP) in the plasma of malignant solid tumors, and to explore its expression in malignant solid tumor; (2) to compare the expression level of TF+MP in malignant solid tumor, and to discuss whether it is with the progression of tumor. (3) to compare the expression level of TF+MP in malignant solid tumor and thrombosis, to explore the role of TF+MP in the formation of tumor and thrombosis; (4) to detect the level of TF+MP expression before and after anesthesia and to explore the effect of anesthetic factors on the TF+MP in the tumor patients; (5) to detect the expression level of TF+MP in patients with malignant solid tumor before and after operation, Methods: 36 patients with malignant solid tumors in our hospital were collected and 36 cases of malignant solid tumors were collected in our hospital and 29 patients in the physical examination were used as the control group. The expression level of the patients with malignant solid tumor was detected and the different stages of the tumor were compared, the thrombosis and the anesthesia were combined. The change of TF+MP during and before and after the operation: the control group took the early morning empty venous blood, the experimental group took the empty abdominal vein blood before anesthesia, after anesthesia and after the operation, and then obtained the platelet poor plasma (PPP) after the two centrifugation. The immunofluorescence technique was used to label the FITC-Annexin- V antibody and PE-TF antibody. The particle TF+MP was then detected by flow cytometry and analyzed the target particle TF+MP: diameter 0.1-1.0um, FITC-Annexin- V antibody and PE-TF antibody positive. Finally, the expression of TF+MP was compared in each group. Results: (1) the overall expression level of TF+MP between the patients with malignant solid tumor and the healthy control group: TF+MP in malignant solid tumor. The expression in the patient was higher than that in the healthy group: (25.45 + 16.04)%vs (11.31 + 6.22)%, t=3.934, P0.001, indicating high expression of TF+MP in patients with malignant solid tumor. (2) the expression level of TF+MP in the various stages of the tumor: there was no significant difference in the level of TF+MP from the healthy group in stage I tumor patients: (15.22 + 12.93)%vs (11.31 + 6.22)%, t=1.14 7, P=0.261; the TF+MP expression of the tumor patients in stage II - IV was significantly higher than that in phase I (P0.05), while there was no significant change in the expression of TF+MP between stage II, stage III and IV tumor patients (P0.05): (15.22 + 12.93)%vs (28.89 + 8.24)%vs (28.03 + 19.38)%vs (33.60 + 7.85)%, suggesting that the expression of malignant solid tumor in the advanced stage was significantly higher. (3) TF+MP in malignant The expression level in patients with solid tumor combined with VTE: the expression of TF+MP in patients with malignant solid tumors with VTE is significantly higher than those without VTE: 33%, the increase in TF+MP may play an important role in the patients with malignant solid tumor and thrombosis. (4) the expression level of TF+MP in patients with malignant solid tumor before and after anesthesia: There was no significant change in the level of TF+MP expression in the patients with malignant solid tumor before and after anesthesia: (25.45 + 16.04)%vs (24.68 + 15.05)%, t=0.206, P=0.838, suggesting that the anesthetic factors have no significant influence on the expression of TF+MP after operation. (5) the level of TF+MP in the patients with malignant solid tumor before and after operation: the expression of TF+MP in patients with malignant solid tumor before and after operation. The increase after operation: (24.68 + 15.05)%vs (32.99 + 17.92)%, t=2.074, P=0.042, suggesting that the operation can promote the release or expression of TF+MP in the tumor patients. Conclusion: (1) the expression of TF+MP in the patients with malignant solid tumor is higher than that of the healthy control group, and the II, III, IV stage is higher than the I stage, suggesting the high expression of TF+MP in the malignant solid tumor, and along with the tumor progression. The high expression level of TF+MP may indicate the occurrence of malignant solid tumor and reflect the progression of tumor; (2) TF+MP may be closely related to the formation of easy thrombosis in malignant solid tumors. (3) the formation of easy thrombosis in patients with malignant solid tumor may be related to the high expression of TF+ MP in operation, and the anesthesia factors do not affect the expression of TF+MP. It is not related to postoperative thrombosis in patients with malignant solid tumors. To sum up, TF+MP may be associated with the occurrence, progression and thrombosis of malignant solid tumors. It is likely to be an important factor in the easy onset of thrombosis in patients with malignant solid tumor after surgery.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R730.5

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