P53、CyclinD1、HIF-1α等多指标积分系统预测鼻咽癌放疗敏感性的研究

发布时间：2018-01-16 09:47

本文关键词：P53、CyclinD1、HIF-1α等多指标积分系统预测鼻咽癌放疗敏感性的研究　出处：《中南大学》2011年硕士论文　论文类型：学位论文

【摘要】：目的：从P53.CyclinDl、Ki-67、HIF-1α及ATM五个备选指标中,筛选具有统计学意义的指标,建立一个多指标积分系统以预测鼻咽癌放疗敏感性。方法：采用回顾性研究的方法,收集并筛选出30例于2005年-2010年间在中南大学湘雅二院肿瘤科接受放射治疗的鼻咽癌患者的病理标本,入选患者均采用等中心照射,常规分割鼻咽部6MVX线肿瘤剂量为70-80Gy/35-40次,颈部6MVX线加10MeV电子线50-66Gy/25-33次。根据放疗后疗效将患者分为三组：①放疗敏感组(A组)10例,②放疗后两年内复发组(B组)10例,③放疗残留组(C组)10例。所收集标本均用石蜡包埋,其病理类型均为低分化鳞癌。将患者的病理标本制成普通组织切片,进行HE染色,光镜下观察,再次确定病理诊断。用免疫组化方法检测患者鼻咽癌组织中P53. CyclinDl、Ki-67、HIF-1及ATM蛋白表达情况,应用SPSS 13.0统计软件,分析这些指标与鼻咽癌放疗敏感性之间的相关性,筛选出有统计学意义的指标组成积分系统。得出本实验多指标积分系统的评分标准如下： P53(-)0;P53(+)1;P53(++～+++)2 HIF-1α(-)0;HIF-1α(+)1;HIF-1α(++～+++)2 Cyclin D1(-)2; Cyclin D1(+)1;Cyclin D1(++～+++)0 结果： 1.P53蛋白水平在A组中低于B组(U=20.00,p0.05),亦低于C组(U=21.00,p0.05),而在B、C两组之间其表达水平无统计学差异(U=40.50,p0.05)。 2.CyclinD1蛋白水平在A组中高于B组(U=24.50,p0.05),亦高于C组(U=24.50,p0.05),而在B、C两组之间其表达水平无统计学差异(U=47.00,p0.05)。 3.Ki-67蛋白水平在A组和B组间无统计学差异(U=50.00,p0.05),和C组间亦无统计学差异(U=46.00,p0.05),同样B组和C组间亦无统计学差异(U=46.00,p0.05)。 4.HIF-1α蛋白水平在A组中低于B组(U=23.50,p0.05),亦低于C组(U=19.00,p0.05),而在B、C两组之间其表达水平无统计学差异(U=45.00,p0.05)。 5.ATM蛋白水平在A组和B组间无统计学差异(U=50.00,p0.05),和C组间亦无统计学差异(U=36.00,p0.05),同样B组和C组间亦无统计学差异(U=32.50,p0.05)。 6.本研究得出的多指标积分系统中A组积分均数为：1.80,B组积分均数为4.00,C组积分均数为4.40,其积分值在A组和B组间有统计学差异(p0.01),在A组和C组间亦有统计学差异(p0.01),而在B组和C组间则无统计学差异(p0.05)。结论：1.NPC患者中p53及HIF-1α高表达组放疗敏感性较低表达组下降,而CyclinD1高表达组放疗敏感性较低表达组增高。 2.未发现NPC患者ATM及Ki-67蛋白表达水平与放疗敏感性间有明显相关性。 3.多指标积分系统总积分值3时,放疗敏感性较高,总积分值3时,放疗敏感性较低。
[Abstract]:Objective: to screen the statistically significant indexes from five alternative indexes, P53. CyclinDlnki-67HIF-1 伪 and ATM. A multi-index integral system was established to predict the radiosensitivity of nasopharyngeal carcinoma (NPC). Methods: a retrospective study was conducted to collect and screen 30 patients with nasopharyngeal carcinoma (NPC) receiving radiotherapy from 2005 to 2010 in the Department of Oncology, Xiangya second Hospital, Central South University. All the patients were treated with isocentric irradiation. The tumor dose of 6MVX in nasopharynx was 70-80 Gy / 35 to 40 times. Cervical 6MV X ray and 10MeV electron ray 50-66 Gy / 25-33 times. According to the curative effect after radiotherapy, the patients were divided into three groups: 1 radiation sensitive group (n = 10) and group A (n = 10). 2 within two years after radiotherapy, 10 patients in Group B and 10 patients in Group C in Group B were treated with residual radiotherapy. All the collected specimens were embedded in paraffin wax. The pathological types were all poorly differentiated squamous cell carcinomas. The pathological specimens of the patients were made into common sections and stained with HE, and observed under light microscope. Immunohistochemical method was used to detect the expression of p53. CyclinDlnki-67HIF-1 and ATM protein in nasopharyngeal carcinoma. SPSS 13.0 statistical software was used to analyze the correlation between these indexes and the radiosensitivity of nasopharyngeal carcinoma (NPC). The index of statistical significance is selected to form the integral system. The scoring criteria of the multi-index integral system in this experiment are as follows: P53A1-0; P53; P53 (~ 2 HIF-1 伪 -0); HIF-1 伪; HIF-1 伪 (~ (2) Cyclin D _ (1) O ~ (2)); Cyclin D1; Cyclin D1 (~ 0) Results: 1. The level of p53 protein in group A was lower than that in group B (P 0.05), and that in group C was lower than that in group C (P 0.05). There was no statistical difference in the expression level between the two groups. 2. The level of CyclinD1 protein in group A was higher than that in group B (24.50 p0.05), and higher than that in group C (24.50) p0.05, while in group B, the level of CyclinD1 protein was higher than that in group B (P < 0.05). There was no statistical difference in the expression level between the two groups. 3. There was no significant difference in Ki-67 protein level between group A and group B, and there was no significant difference between group A and group C (P 0.05). Similarly, there was no statistical difference between group B and group C (P 0.05). 4. The level of HIF-1 伪 protein in group A was lower than that in group B (23.50) (p0.05), and in group C (19.00) (p0.05), but in group B. There was no statistical difference in the expression level between the two groups. 5. There was no significant difference in the level of ATM protein between group A and group B, and there was no significant difference between group A and group C (P 0.05). Similarly, there was no statistical difference between group B and group C, and there was no significant difference between group B and group C (P 0.05). 6. In the multi-index integral system, the average value of group A integral is 1: 1.80 and the mean of group B is 4. 00 and the mean of group C is 4. 40. There was a statistical difference between group A and group B (p0.01), and between group A and group C (p0.01). There was no significant difference between group B and group C (p 0.05). Conclusion 1. The radiosensitivity of the high expression group of p53 and HIF-1 伪 was lower than that of the low expression group, while the radiosensitivity of the high expression group of CyclinD1 was higher than that of the low expression group. 2. There was no significant correlation between the expression of ATM and Ki-67 protein and radiosensitivity in patients with NPC. 3. The total integral value of multiple index integral system is 3:00, the sensitivity of radiotherapy is high, the total integral value is 3:00, the sensitivity of radiotherapy is low.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.63

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