血清铁蛋白在前列腺癌诊断与预后判断中的应用价值

发布时间：2018-03-23 12:15

本文选题：前列腺癌　切入点：铁蛋白　出处：《浙江大学》2017年硕士论文

【摘要】：目的铁蛋白是人体内主要的储铁蛋白。多种肿瘤血清铁蛋白水平均有升高,比如肝癌、肺癌、乳腺癌等等。已有研究发现血清铁蛋白的升高与多种肿瘤患病风险显著相关。此研究的目的在于探讨血清铁蛋白与前列腺癌患病风险之间的关系,以及血清铁蛋白在前列腺癌诊断和预后判断中的应用价值。方法收集浙江大学附属第一医院2011年1月至2015年10月间组织学上确诊为前列腺癌2002例和前列腺增生951例病人临床资料,包括血清铁蛋白、血清PSA、Gleason评分。采用免疫组化Envision二步法检测129例前列腺癌组织蜡块,31例前列腺增生组织蜡块中铁蛋白表徶水平。结果1.血清铁蛋白的升高与血清PSA的升高和前列腺癌患病风险显著相关(比值比=1.20,95%可信区间:1.13-1.36)。2.前列腺癌病人中血清铁蛋白水平与淋巴结浸润和远处转移显著相关(P值0.001)。3.前列腺癌病人血清铁蛋白与Gleason评分显著相关(P值0.001)。4.有高铁蛋白血症(血清铁蛋白大于400ng/mL)的前列腺癌病人中血清PSA判断预后的准确性有所提高(Gleason评分-总PSA,R=0.38;Gleason评分-游离 PSA,R=0.49)。5.较前列腺增生,前列腺癌组织铁蛋白表达水平随着前列腺癌恶性程度的增加而增加(P值0.001)。前列腺癌组织铁蛋白表达水平与相应病人血清铁蛋白水平显著相关(R=0.81)。6.前列腺癌病人血清铁蛋白与炎症标志物C反应蛋白无相关性。结论血清铁蛋白的升高是前列腺癌患病的风险因素,其在前列腺诊断(尤其是对于血清铁蛋白400ng/mL的老年患者)和预后判断中具有一定的应用价值,并可以作为一个补充性的生物标记物提高血清PSA检测在前列腺癌预后判断中的准确性。
[Abstract]:Objective ferritin is the main ferritin in human body. The serum levels of ferritin are increased in many kinds of tumors, such as liver cancer and lung cancer. Breast cancer and so on. It has been found that the increase of serum ferritin is significantly associated with the risk of multiple tumors. The aim of this study was to explore the relationship between serum ferritin and the risk of prostate cancer. The value of serum ferritin in the diagnosis and prognosis of prostate cancer. Methods 2002 cases of prostate cancer and 951 cases of prostatic hyperplasia were collected from January 2011 to October 2015 in the first affiliated Hospital of Zhejiang University. Clinical data of patients, Including serum ferritin, Serum PSA-Gleason score. Immunohistochemical Envision two-step method was used to detect the level of ferritin in paraffin wax of 31 cases of prostate hyperplasia. 1. The elevation of serum ferritin and the increase of serum PSA and prostatic gland. 2. There was a significant correlation between serum ferritin level and lymph node invasion and distant metastasis in prostate cancer patients (P = 0.001n.3.The serum ferritin level was significantly correlated with Gleason score in patients with prostate cancer. P value was 0.001g 路4.The accuracy of serum PSA in prostatic cancer patients with ferrigenemia (serum ferritin > 400ng / mL) was improved, and the Gleason score was 0.38 Gleason score. The expression of ferritin in prostate cancer tissue increased with the increase of malignant degree of prostate cancer (P = 0.001). There was a significant correlation between the expression level of ferritin in prostate cancer tissue and the serum ferritin level in patients with prostate cancer. There was no correlation between ferritin and C-reactive protein. Conclusion the increase of serum ferritin is a risk factor for prostate cancer. It has some value in the diagnosis of prostate (especially in elderly patients with serum ferritin 400ng/mL) and in the judgment of prognosis. It can be used as a supplementary biomarker to improve the accuracy of serum PSA in the prognosis of prostate cancer.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.25

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