喉癌中HPV感染与EGFR之间的相关性研究

发布时间：2018-02-26 18:18

  本文关键词： 喉癌 HPV EGFR 免疫组化　出处：《大连医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：喉癌是头颈部常见恶性肿瘤之一，，发病率仅次于鼻咽癌，是一种多因素致病、多基因参与、多步骤发展的恶性疾病,占头颈部肿瘤的13.9%[1]。人类乳头状瘤病毒(HPV)属乳多空DNA病毒，具有嗜上皮性,与多种上皮增生性病变及恶性肿瘤的发生和发展有关，HPV并非喉癌唯一的致病因子，且单独HPV感染不足以引起人正常鳞状上皮细胞的恶变，因此推断HPV感染并发生恶变还需要其他因子的协同，来启动这种病毒的致癌活性从而使得被感染的细胞癌变。近年来发现EGFR与人类的肿瘤关系密切，表皮生长因子受体EGFR是一种跨膜糖蛋白，被认为是癌基因,在人体多种恶性肿瘤组织中均过表达，目前以EGFR为靶点的靶向治疗已成为热点。喉癌的形成与HPV感染及EGFR过表达之间是否有一定的关系？HPV感染对EGFR过表达有何影响？两者在喉癌的发病过程中扮演什么角色？针对这些问题，本实验采用免疫组织化学法检测喉癌组织中HPV16/18及EGFR的表达情况,研究HPV16/18感染与EGFR过表达的关系,以期进一步探讨HPV、EGFR与喉癌的临床病理特征的关系。 目的：检测喉癌组织中人乳头状瘤病毒HPV与表皮生长因子受体EGFR的表达情况，研究喉癌发生、发展的分子生物学机制，为早期诊断、预后判断及分子靶向治疗提供客观参考指标。 方法：收集大连医科大学附属一院病理科存档的2003年～2011年间活检喉癌组织标本63例，据调查所有标本均为鳞癌且未经放化疗。标本经甲醛固定,石蜡包埋,组织切片，HE染色、病理证实后用免疫组化二步法测定HPV16/18和EGFR在喉癌组织中的表达情况。应用SPSS17.0统计软件，计数资料采用χ2检验对实验结果进行分析，检验水准α=0.05，差异显著性标准为P0.05。 结果： 1.HPV感染情况:在喉癌组织、喉癌癌旁组织和良性声带息肉中，HPV感染率分别为34.92%（22/63）、30.00%（6/20）和5.00%（1/20）。在喉癌组织及癌旁组织中HPV感染率明显比良性声带息肉高（P＜0.05），但喉癌组织与癌旁组织间无明显相关性（P＞0.05）。 2.EGFR蛋白表达情况:在喉癌组织、喉癌癌旁组织和良性声带息肉组织中，EGFR蛋白阳性表达率分别为77.78%（49/63）、10.00%(2/20)和0.00%(0/20)，喉癌组织显著高于癌旁及良性声带息肉（P＜0.05）。 3.HPV感染与EGFR蛋白表达之间的相互关系：在喉癌中HPV感染组的EGFR蛋白阳性表达率高于未感染组,两者差异具统计学意义(P0.05),HPV蛋白阳性率与EGFR蛋白过表达呈正相关。 结论： 1.在喉癌中存在着一定比例的HPV16/18感染，可推测HPV感染与喉癌的发生发展有一定的关系，HPV感染可能是喉癌诱发的重要原因之一。 2.EGFR的过度表达在喉粘膜的癌变过程中是一个重要的早期指标，可能对喉癌的启动有重要的作用，喉癌的发病可能与EGFR过表达相关。 3.HPV16/18感染与EGFR蛋白的表达呈正相关，HPV感染引起EGFR过表达可能是喉癌的发病机制之一。 4.联合检测HPV感染、EGFR蛋白表达情况有助于喉癌的预警和诊断。
[Abstract]:Laryngeal carcinoma is a common malignant tumor in head and neck, after the incidence of nasopharyngeal carcinoma, is a multifactorial disease, multiple genes, multiple steps of the development of malignant diseases, accounting for head and neck cancer 13.9%[1]. human papilloma virus (HPV) belongs to Papovaviridae DNA virus, with eosinophilic epithelial, occurrence and development with a variety of epithelial hyperplasia lesions and malignant tumors, HPV is not the only pathogenic factor of laryngeal cancer, and HPV infection alone is not sufficient to cause human normal squamous cell malignant tumor, thus infer HPV infection and canceration and coordination also requires other factors, to start the virus so that the carcinogenic activity of cancer cells was found in recent years between infection. EGFR closely with human tumors, epidermal growth factor receptor EGFR is a transmembrane glycoprotein, is considered to be the cancer gene, in tissues of human malignant tumors were over expressed, at EGFR Targeting therapy has become a hot topic. The formation and infection of HPV and EGFR in laryngeal carcinoma whether there is a certain relationship between the expression of HPV? What is the effect of EGFR infection on the expression of the two? What is the role in the pathogenesis of laryngeal cancer? To solve these problems, the immunohistochemical expression of HPV16/18 and EGFR detection laryngeal carcinoma textile chemical method, the infection of HPV16/18 and EGFR expression, to further explore the relationship between HPV, EGFR and clinicopathologic characteristics of laryngeal carcinoma.
Objective: to detect the expression of human papillomavirus HPV and epidermal growth factor receptor EGFR in laryngeal carcinoma tissues, and to study the molecular biological mechanism of laryngeal carcinogenesis and development, so as to provide an objective reference for early diagnosis, prognosis and molecular targeted therapy.
Methods: collect the pathological Department of the First Affiliated Hospital of Dalian Medical University from 2003 to 2011 biopsy specimens of 63 cases of laryngeal carcinoma, according to a survey of all specimens were squamous cell carcinoma and without chemotherapy. Specimens were formalin fixed, paraffin embedded tissue sections, HE staining, pathological expression by immunohistochemical determination of HPV16/18 and EGFR in two steps laryngeal carcinoma confirmed. Using SPSS17.0 statistical software, count data using chi 2 test to analyze the experimental results, a =0.05 level test, difference standard for P0.05.
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