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ΔNp73及p53(突变型)在皮肤非黑素恶性肿瘤中的表达及意义

发布时间:2018-05-04 16:17

  本文选题:△Np73 + p53 ; 参考:《昆明医学院》2010年硕士论文


【摘要】: 目的:应用免疫组织化学技术对p73异构体(△Np73)在皮肤非黑素恶性肿瘤(鳞状细胞癌、基底细胞癌、鲍温病)、癌前病变(日光性角化病)、良性增殖性疾病(寻常型银屑病、脂溢性角化症)及正常人皮肤中的表达进行对照研究,同时与p53(在本文除非特别指出,均为突变型)在这些疾病中的表达进行对照。初步探讨△Np73在皮肤非黑素恶性肿瘤中的表达和意义,及其在肿瘤恶性程度及预后评估中的实际应用价值,以及△Np73与p53在良恶性增殖性疾病中表达的相关性。 方法:收集、整理昆明医学院第一临床学院皮肤科病理室及病理科保存的符合诊断标准的皮肤高、中、低分化鳞状细胞癌(SCC)60例及基底细胞癌(BCC)、鲍温病(BD)、日光性角化病(AK)、寻常型银屑病(PS)、脂溢性角化症(SK)各20例,并选取我科皮肤手术室及颌面外科手术切除的正常人皮肤(skin)10例。经过脱水、包埋、切片、染色等步骤,应用免疫组化技术对切片进行△Np73及p53的染色,最后评分,统计、分析各病种阳性病例数之间的差异以及△Np73、p53两个指标之间的相关性。 结果:p53在所有病种中均有阳性表达,但在皮肤非黑素恶性肿瘤(SCC、BCC、BD)和癌前病变(AK)中的表达阳性率明显超过良性增殖性疾病及正常人皮肤,差异有显著性(P0.05),非黑素恶性肿瘤(SCC、BCC、BD)与癌前病变(AK)之间的表达阳性率无显著性差异(PO.05):△Np73在全部恶性肿瘤(SCC、BCC、BD)、部分良性增殖性病(PS)及癌前病变(AK)均有阳性表达,在部分良性增殖性病(SK)及正常人皮肤(skin)中无表达,其中SCC与AK的表达率明显高于其它病种,差异有统计学意义(P<0.05),两者之间的差异无显著性差异(P0.05);△Np73蛋白在各病种中的阳性表达率与发病部位(曝光部位与非曝光部位)、患者性别、年龄均无统计学差异(P0.05);△Np73和p53在SCC中的表达呈正相关(rs=0.348,P=0.007),在其它病种中的表达无相关性(P0.05)。 结论:p53(突变型)阳性对诊断及鉴别良恶性增殖性疾病有一定意义,但在鉴别皮肤癌前病变与非黑素恶性肿瘤方面特异性较差;△Np73在SCC、AK的诊断中具有比较特异的诊断价值,尤其在与其他疾病的鉴别诊断中可能具有较强的实际应用价值,但对SCC病理分级无明显意义;△Np73蛋白的阳性表达率与患者的年龄、性别、发病部位无显著相关性;△Np73和p53在SCC中的表达具有相关性,提示两者在恶性肿瘤的发病中关系密切;联合应用△Np73和p53的可能对良恶性疾病的鉴别诊断更具有临床意义;△Np73与皮肤非黑素恶性肿瘤之间的复杂关系仍不十分清楚,尚需要更多的大样本量及具有详细临床资料的病例研究进一步阐明。
[Abstract]:Objective: to study the expression of p73 isomer (Np73) in non-melanoma (squamous cell carcinoma, basal cell carcinoma, Bowen's disease, precancerous lesion (sunburn keratosis), benign proliferative disease (psoriasis vulgaris) by immunohistochemical technique. The expression of seborrheic keratosis and normal human skin was compared with that of p53 (all mutant types unless specifically indicated in this paper). To explore the expression and significance of Np73 in non-melanoma of skin, and its practical value in the evaluation of malignant degree and prognosis, as well as the correlation between Np73 and p53 expression in benign and malignant proliferative diseases. Methods: collect and arrange the skin of the Department of Dermatology and Pathology of the first Clinical Hospital of Kunming Medical College. There were 60 cases of poorly differentiated squamous cell carcinoma (SCC) and 20 cases of basal cell carcinoma (BCC), Balwin's disease (BDN), solar keratosis (AKK), psoriasis vulgaris (PSN), seborrheic keratosis (SKK). After the steps of dehydration, embedding, section and staining, Np73 and p53 were stained by immunohistochemical technique. Finally, the difference between the positive cases of each disease and the correlation between Np73 and p53 were analyzed. Results the positive expression rate of protein p53 in all kinds of diseases was significantly higher than that in benign proliferative diseases and normal skin, but the positive rate was higher in SCC BCC BCCBDB and precancerous lesions than in benign proliferative diseases and normal skin. There was no significant difference between the positive rate of SCC BCCBDD) and precancerous lesion (AKK). There was no significant difference in the positive expression of Np73 in all malignant tumors (SCC, BCC, BDD) and precancerous lesion (AKK). The positive expression of Np73 was found in all malignant tumors, including SCC, BCC, BCCBDD) and precancerous lesion (AK). There was no expression of SCC and AK in some benign proliferative venereal diseases (SKK) and normal human skin. The expression rate of SCC and AK was significantly higher than that of other diseases. The difference was statistically significant (P < 0.05), but there was no significant difference between the two groups (P < 0.05). The positive expression rate of Np73 protein and the location of the disease (exposure site and non-exposure site, gender of the patient) were significantly higher than that of the other two groups (P < 0.05), and there was no significant difference between the two groups (P < 0.05). The expression of Np73 and p53 in SCC was positively correlated with the expression of P0. 007, but not in other diseases. Conclusion the positive expression of Np73 has a certain significance in the diagnosis and differential diagnosis of benign and malignant proliferative diseases, but it is less specific in differentiating skin precancerous lesions from non-melanoma, and Np73 has a relatively specific diagnostic value in the diagnosis of SCC / AK. Especially in the differential diagnosis of other diseases, it may have a strong practical value, but has no significant significance for SCC pathological grade, the positive expression rate of Np73 protein has no significant correlation with the age, sex and location of the disease. The expression of Np73 and p53 in SCC is correlated, which indicates that the expression of Np73 and p53 is closely related to the pathogenesis of malignant tumors, and the combination of Np73 and p53 may be of clinical significance in the differential diagnosis of benign and malignant diseases. The complex relationship between Np73 and non-melanoma of skin is still unclear, and more case studies with large sample size and detailed clinical data are needed.
【学位授予单位】:昆明医学院
【学位级别】:硕士
【学位授予年份】:2010
【分类号】:R739.5

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