MUC5AC、骨桥蛋白和Caveolin-1在Paget病中的表达

发布时间：2018-02-16 05:16

本文关键词： 乳房Paget病乳房外Paget病免疫组化 MUC5AC 骨桥蛋白 Caveolin-1　出处：《大连医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：背景 Paget病(Paget 's disease,PD)首次是由英国外科物理学家James Paget在1874年报道，其发病年龄一般为40～60岁，比较容易发生于乳头及乳晕部和富有大汗腺的区域。乳头及乳晕处的Paget病称为乳房Paget病(Mammary Paget 'sdisease,MPD)，其他部位的称为乳房外Paget病(Extramammary Paget 'sdisease,EPD)。该病特点为发病部位可见界限清楚的红色斑片，其表面有渗出、结痂或角化性鳞屑，可以逐渐向周围扩大，，经数月或数年后常浸润周边或者深层，严重者甚至发生溃疡，自觉不同程度的瘙痒，少数可有疼痛。 PD的发病机制和组织来源一直存在着很大的争议。人们利用免疫组化技术对PD进行不断地深入研究，对PD的发病机制和组织来源有了更多的了解。绝大多数学者认为MPD的发生和发展与乳腺癌有很大的关联，认为MPD可能是乳腺原位腺癌的表皮转移。而EPD则与结肠、直肠、肛门及邻近内脏器官的恶性肿瘤或浸润性肿瘤有一定的关联。本文研究了MUC5AC(Gastric mucin M1,胃粘液素抗原)、OPN(Osteopontin,骨桥蛋白)和Caveolin-1(小窝蛋白1)三种免疫标志物在MPD和EPD中的表达情况，并探讨其表达意义，期望可以进一步揭示MPD和EPD的组织来源。目的通过研究MUC5AC、骨桥蛋白和Caveolin-1在MPD和EPD中的表达情况，探讨MPD和EPD的组织学起源及其表达意义。方法对沈阳军区总医院皮肤科已经明确诊断的26例PD患者(其中MDP和EDP患者各13例)的病理组织蜡块和5例正常组织蜡块的进行免疫组化染色，比较这三种抗体在MPD和EPD中的表达情况。结果 1. MUC5AC的表达情况：MUC5AC在正常表皮的细胞质中弱阳性表达，表达率为60%；在PD的细胞质中表达，其中强阳性表达率为30.77%，阳性表达率为26.92%，弱阳性表达率为30.77%；在EPD的细胞质中表达，其中强阳性表达率为46.15%，阳性表达率为23.08%，弱阳性表达率为23.08%；在MPD的细胞质中表达，其中强阳性表达率为15.38%，阳性表达率为30.77%，弱阳性表达率为38.46%。 MUC5AC在EPD中强阳性表达率为46.15%，而在MPD中的强阳性表达率为15.38%，表明MUC5AC在EPD中的强阳性表达率明显高于MPD；在EPD中的阳性表达率为23.08%，而在MPD中的阳性表达率为30.77%，表明MUC5AC在MPD中的阳性表达率略高于EPD；在EPD中的弱阳性表达率为23.08%，而在MPD中的弱阳性表达率为38.46%，表明MUC5AC在MPD中的弱阳性表达率略高于EPD。总体来说，MUC5AC在EPD中的表达率要高于MPD。而统计学结果显示P=0.1210.05，MUC5AC在EPD和MPD的表达上没有差异。 2. OPN的表达情况：OPN在正常表皮的细胞质中表达，强阳性率为20%，阳性率为40%；在PD的细胞质中有表达，其中强阳性表达率为15.39%，阳性表达率为26.92%，弱阳性表达率为50%；在EPD的细胞质中表达，其中强阳性表达率为23.08%，阳性表达率为38.46%，弱阳性表达率为38.46%；在MPD的细胞质中表达，其中强阳性表达率为7.69%，阳性表达率为15.38%，弱阳性表达率为69.23%。 OPN在EPD中的强阳性表达率为23.08%，而在MPD中的强阳性表达率为7.69%，表明OPN在EPD中的强阳性表达率明显高于MPD；OPN在EPD中的阳性表达率为38.46%，而在MPD中的阳性表达率为15.38%，表明OPN在EPD中的阳性表达率高于MPD；在EPD中的弱阳性表达率为38.46%，而在MPD中的弱阳性表达率为69.23%，表明OPN在MPD中的弱阳性表达率高于EPD。总体来说，OPN在EPD中的表达率要高于MPD。统计学结果显示P=0.0450.05， OPN在EPD和MPD的表达上有差异。 3. Caveolin-1的表达情况：Caveolin-1在正常表皮的细胞膜/细胞质中均为弱阳性表达，表达率为100%；在PD的细胞膜/细胞质中均有表达，强阳性表达率为15.39%，阳性表达率为50%，弱阳性表达率为26.92%；在EPD的细胞膜/细胞质中有阳性和弱阳性表达，其表达率分别为61.54%、30.77%；在MPD的细胞膜/细胞质中均有表达，强阳性表达率为30.77%，阳性表达率为38.46%，弱阳性表达率为23.08%。 Caveolin-1在EPD中的无强阳性表达，而在MPD中的强阳性表达率为30.77%，提示Caveolin-1在MPD中的强阳性表达率明显高于EPD。总体来说，Caveolin-1在MPD中的表达率要高于EPD。统计学结果显示P=0.2220.05，Caveolin-1在EPD和MPD的表达上没有差异。结论 1.MUC5AC在EPD和MPD中的表达无差别； 2.OPN在EPD和MPD中的表达有显著差异(P=0.0450.05)； 3.Caveolin-1在EPD和MPD中的表达无差别。
[Abstract]:Background Paget ' s disease ( PD ) was first reported in 1874 by James Paget , a British surgeon , whose age is generally between 40 and 60 years old and is relatively easy to occur in the nipple and areola part and regions with large sweat glands . Paget ' s disease at the nipple and areola is called breast Paget ' s disease , and the other part is called extramammary Paget ' s disease ( Extramammary Paget ' s disease , EPD ) . The disease is characterized by a clear red spot on the surface of the disease , which has exudation , scabs or keratotic scales , and can gradually expand to the periphery . After months or years , it can infiltrate the periphery or the deep layer , and the serious person even has ulcer , and can feel different degrees of itching , and a few can have pain . This paper studies the expression of three kinds of immune markers such as MUC5AC and Caveolin - 1 , and discusses the significance of the expression of the three markers of MUC5AC and Caveolin - 1 . Purpose By studying the expression of MUC5AC , bone bridge protein and Caveolin - 1 , the histological origin and its expression significance were discussed . method Immunohistochemical staining was performed in 26 PD patients ( 13 patients with MDP and EDP ) and 5 normal tissue wax blocks in Department of Dermatology of Shenyang Military Region . Results 1 . MUC5AC expression : MUC5AC was weakly positive in the cytoplasm of normal epidermis , the expression rate was 60 % , the positive rate of expression was 30.77 % , the positive expression rate was 26.92 % , the weak positive expression rate was 23.08 % , the positive expression rate was 15.38 % , the positive expression rate was 30.77 % , and the weak positive expression rate was 38.46 % . The strong positive rate of MUC5AC in EPD was 46.15 % , and the positive rate of expression of MUC5AC was 15.38 % . The positive rate of MUC5AC was 23.08 % in EPD . The positive rate of MUC5AC was 23.08 % in EPD . 2 . The positive expression rate was 15.39 % , the positive expression rate was 26.92 % , the weak positive expression rate was 38.46 % , the positive expression rate was 38.46 % , the weak positive expression rate was 38.46 % , the positive expression rate was 15.38 % , and the weak positive expression rate was 69.23 % . The strong positive expression rate in EPD was 23.08 % , and the strong positive expression rate in EPD was 7.69 % . The positive expression rate in EPD was 38.46 % , whereas the positive expression rate was 38.46 % in EPD . The positive expression rate in EPD was 38.46 % . The expression rate in EPD was higher than that in EPD . 3 . The expression of Caveolin - 1 was found to be weakly positive in the cell membrane / cytoplasm of the normal epidermis , the expression rate was 100 % , the positive expression rate was 15.39 % , the positive expression rate was 50 % , the weak positive expression rate was 26.92 % , the positive expression rate was 30.77 % , the positive rate of expression was 30.77 % , the positive expression rate was 38.46 % , and the weak positive expression rate was 23.08 % . The positive expression rate of Caveolin - 1 was 30.77 % . The expression rate of Caveolin - 1 was higher than that in EPD . Conclusion 1 . There was no difference in the expression of MUC5AC in EPD and mpd ; 2 . There was a significant difference in the expression between EPD ( P = 0.0450.05 ) and EPD ( P = 0.0450.05 ) . 3 . The expression of Caveolin - 1 in EPD was no difference .

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.5

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