探讨缺氧诱导因子-1α与上皮间质转化相关蛋白在膀胱尿路上皮癌中的表达及其临床意义

发布时间：2018-02-09 02:10

本文关键词： 膀胱尿路上皮癌缺氧诱导因子-1α E-钙粘蛋白波形蛋白生存率　出处：《南昌大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：研究探讨缺氧诱导因子-1α（hypoxia-inducible factor-1alpha,HIF-1α）和上皮间质转化（epithelial mesenchymal transition,EMT）相关蛋白在膀胱尿路上皮癌（urothelial carcinoma of the bladder,UCB）组织中的表达情况，探讨相关蛋白表达与术后病理分期分级关系及与患者预后关系。方法：采用免疫组织化学法检测97例膀胱尿路上皮癌组织中缺氧诱导因子-1α（HIF-1α）、E-钙粘蛋白（E-cadherin）、波形蛋白（Vimentin）的表达情况。随访97例标本所对应的术后患者，主要随访术后患者并发症发生情况包括近期并发症、远期并发症及生存状况等，调查膀胱尿路上皮癌患者术后1年、2年、5年生存率。采用免疫组织化学法检测5例正常膀胱组织中缺氧诱导因子-1α、E-钙粘蛋白、波形蛋白的表达情况进行对照。结果：选取97例行膀胱全切术住院患者手术切除标本，病理证实为膀胱尿路上皮癌。分为：低级别尿路上皮癌（low-grade carcinoma,LGC）38例；高级别尿路上皮癌（high-grade carcinoma,HGC）59例。免疫组织化学法检测结果示低级别尿路上皮癌（LGC）：缺氧诱导因子-1α：阳性率52.6%（20/38）、阴性率47.4%（18/38）。E-钙粘蛋白：阳性率55.3%（21/38）、阴性率44.7%（17/38）；波形蛋白：阳性率36.8%（14/38）、阴性率63.2%（24/38）。高级别尿路上皮癌（HGC）：缺氧诱导因子-1α：阳性率72.9%（43/59）、阴性率27.1%（16/59）。E-钙粘蛋白：阳性率32.2%（19/59）、阴性率67.8%（40/59）；波形蛋白：阳性率57.6%（34/59）、阴性率42.4%（25/59）。5例正常膀胱组织中免疫组织化学法检测结果示：缺氧诱导因子-1α：阳性率0（0/5）、阴性率100%（5/5）；E-钙粘蛋白：阳性率100%（5/5）、阴性率0（0/5）；波形蛋白：阳性率0（0/5）、阴性率100%（5/5）。低级别尿路上皮癌组随访结果：患者38例，1例患者术后死于肾功能衰竭为非肿瘤死亡；2例患者失随访。随访结果统计如下：1年生存率75.0%（27/36）、2年生存率63.9%（23/36）、5年生存率41.7%（15/36）。高级别尿路上皮癌随访结果：患者59例，1例患者术后死于心功能衰竭，2例患者术后死于肾功能衰竭，1例患者术后死于感染导致的全身脏器功能衰竭，，均为非肿瘤死亡；7例患者失随访。随访结果统计如下：1年生存率71.2%（37/52）、2年生存率40.4%（21/52）、5年生存率13.5%（7/52）。结论：缺氧诱导因子-1α（HIF-1α）、E-钙粘蛋白（E-cadherin）、波形蛋白（Vimentin）在膀胱尿路上皮癌的发生发展中发挥重要作用，随着膀胱尿路上皮癌恶性程度增高，缺氧诱导因子-1α表达增高、E-钙粘蛋白表达下降、波形蛋白表达增高。随着膀胱尿路上皮癌恶性程度增高，患者1年、2年、5年生存率逐渐降低。缺氧诱导因子-1α与E-钙粘蛋白、波形蛋白在膀胱尿路上皮癌发生发展及预后中发挥重要作用，可作为预后判断指标。
[Abstract]:Objective:. To investigate the expression of hypoxia-inducible factor-1 伪 hypoxia-inducible factor-1 alpha-HIF-1 伪 (HIF-1 伪) and epithelial mesenchymal transition (EMT-1 伪) in bladder urothelial carcinoma of the bladderderma, and to explore the relationship between the expression of HIF-1 伪 and postoperative pathological stages and prognosis. Methods:. The expression of hypoxia-inducible factor-1 伪 (HIF-1 伪) -E-cadherin (Vimentin) in 97 cases of bladder urothelial carcinoma was detected by immunohistochemical method. The main postoperative complications included short-term complications, long-term complications and survival status. The survival rate of 1 year, 2 years and 5 years after operation in patients with bladder urothelial carcinoma was investigated. The expression of hypoxia inducible factor-1 伪 -E-cadherin and vimentin in 5 normal bladder tissues were detected by immunohistochemical method. Results:. Ninety-seven inpatients with total cystectomy were selected and proved to be bladder urothelial carcinoma by pathology, including 38 cases of low-grade carcinomatous carcinoma of the urinary tract, and 38 cases of low-grade carcinoma of urinary tract. The results of immunohistochemical method showed that the low grade urothelial carcinoma (LUCC): hypoxia-inducible factor-1 伪: positive rate was 52.66% 20% 38%, negative rate was 47.4% and 1838% .E-cadherin: positive rate 55.33% 21 / 38%, negative rate 44.7T = 17 / 38%; vimentin: positive rate 36.88% 143838%; vimentin: positive rate 36.88% / 143838%; positive rate 55.338% .E-cadherin: positive rate 55.33% 21 / 38%, negative rate 44.7% 17 / 38%; vimentin: positive rate 36.88% 143838%; vimentin: positive rate 36.88% 143838%. High grade urothelial carcinoma HGCU: hypoxia inducible factor-1 伪: positive rate 72.9% 43 / 59%, negative rate 27.1%: positive rate 32.22% 1959%, negative rate 67.840% 40% 59%; vimentin: positive rate 57.66% / 3459%; negative rate 42.440% -59%; negative rate 42.440% 59%; negative rate 42.440% 59%; positive rate 37.840% 40% 59%; vimentin: positive rate 57.66% 3459%; negative rate 42.440% 59%; negative rate 42.440% 59%; negative rate 27.1%; positive rate 32.22% 1959%; negative rate 67.840% 40% 59%; vimentin: positive rate 57.66% 3459%; The results showed that the positive rate of hypoxia inducible factor-1 伪: positive rate 0 / 0 / 5%, negative rate 100% / 5 / 5% E-cadherin: positive rate 100% / 5%, negative rate 0% / 5%; vimentin: positive rate 0 / 0 / 5%, negative rate 100% / 5%. Follow-up results of low grade urothelial carcinoma group: one patient died of renal failure and 2 patients died of non-tumor death after operation. The results of follow-up were as follows: 1 year survival rate was 75.0% 27 / 36%, 2 years survival rate was 63.9% 23 / 36%, and 5 year survival rate was 41.775 / 36. Follow-up results of high grade urothelial carcinoma: one patient died of heart failure and two died of renal failure after operation. One patient died of systemic organ failure caused by infection after operation. The results of follow-up were as follows: 1 year survival rate was 71.2%, 37% / 52%, 2 year survival rate was 40.4% 21 / 52%, 5 year survival rate was 13. 5% / 52%. Conclusion:. Hypoxia-inducible factor-1 伪 (HIF-1 伪) plays an important role in the occurrence and development of bladder urothelial carcinoma. The expression of hypoxia inducible factor -1 伪 (HIF-1 伪) increases and the expression of E-cadherin decreases with the increase of malignancy of bladder urothelial carcinoma. The expression of vimentin increased. With the increase of malignant degree of bladder urothelial carcinoma, the survival rate of 1, 2 and 5 years decreased gradually, hypoxia inducible factor-1 伪 and E-cadherin, Ecadherin, hypoxia-inducible factor-1 伪 and E-cadherin, Vimentin plays an important role in the development and prognosis of bladder urothelial carcinoma and can be used as a prognostic index.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.14

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