脉络膜黑色素瘤染色体变化与病理类型的相关性研究

发布时间：2018-06-30 19:07

本文选题：脉络膜黑色素瘤 + 荧光原位杂交　；参考：《复旦大学》2010年硕士论文

【摘要】： 目的：研究脉络膜黑色素瘤3、6、8号染色体变化情况,明确脉络膜黑色素瘤的病理分型,分析脉络膜黑色素瘤染色体与肿瘤基底部最大直径、肿瘤厚度、病理分型之间的关系。方法：选取复旦大学附属眼耳鼻喉医院2004年4月～2008年12月的住院患者共36例,患者术前拟诊为脉络膜黑色素瘤,所有患者均行眼球摘除手术,术后经病理确诊为脉络膜黑色素瘤。根据modified-chandler病理分型将脉络膜黑色素瘤的病理类型分为：梭形细胞型、混合细胞型和上皮样细胞型。收集患者眼球的石蜡标本,采用荧光原位杂交法检测标本中肿瘤组织3、6、8号染色体的变化,选取18号染色体验证实验的可重复性,并选取标本中正常视网膜组织进行阴性对照。将染色体发生变化的病例进行分组,分析染色体变化与肿瘤病理类型之间的相关性。所有数据利用SPSS15.0软件进行分析。结果：本实验入选的36名病例包括男性21名,女性15名,年龄在23～73岁,民族均为汉族,左眼16例,右眼20例。肿瘤基底部最大平均直径为12.5mm,肿瘤平均厚度为8.9mm。各组病例间的性别比例以及年龄无统计学差异。 36例病例的病理包括：梭形细胞型16例,混合细胞型10例,上皮样细胞型8例,坏死型2例。上皮样细胞型基底部最大直径大于其他两组,但差异无统计学意义。混合细胞型和上皮样细胞型平均厚度高于梭形细胞型,且差异有统计学意义(P0.05)。 36例标本中由于2例标本肿瘤坏死严重,肿瘤细胞缺乏完整的结构,无法检测其染色体情况。其余34例病例中13例有3号染色体缺失,9例有8号染色体缺失,7例有6号染色体缺失。其中4例3、8号染色体同时缺失,4例3、6、8号染色体同时缺失。34例标本18号染色体均正常。对照组正常视网膜组织染色体均未缺失。缺失3号染色体的13例病例中,梭形细胞型3例,混合细胞型5例,上皮样细胞型5例。缺失6号染色体的7例病例中,梭形细胞型1例,混合细胞型3例,上皮样细胞型3例。缺失8号染色体的9例病例中,梭形细胞型1例,混合细胞型4例,上皮样细胞型4例。 3、6、8号染色体缺失与肿瘤基底部最大直径、厚度无统计学差异。3、6、8号染色体缺失与肿瘤病理类型明显相关(P0.05)。混合细胞型、上皮样细胞型中染色体改变高于梭形细胞型的染色体改变(P0.05)。多条染色体的缺失更多见于混合细胞型和上皮样细胞型(P0.05)。结论：脉络膜黑色素瘤中存在3、6和8号染色体的改变,其中3号染色体的缺失最为常见,其次为8号染色体的缺失和6号染色体的缺失。染色体的改变与肿瘤病理类型有明显的相关性。
[Abstract]:Objective: to study the changes of chromosome 3, 8 in choroidal melanoma, to determine the pathological classification of choroidal melanoma, and to analyze the relationship between chromosome size of choroidal melanoma and the maximum diameter of the base of choroidal melanoma, the thickness of tumor, and the pathological type of choroidal melanoma. Methods: from April 2004 to December 2008, 36 patients with choroidal melanoma were selected from the affiliated Eye, ear, nose and throat Hospital of Fudan University. Choroidal melanoma was confirmed by pathology after operation. According to modified-chandler pathological classification, choroidal melanoma was divided into fusiform cell type, mixed cell type and epithelioid cell type. Paraffin wax samples of patients' eyeballs were collected, and the changes of chromosome 38 and 8 were detected by fluorescence in situ hybridization. Chromosome 18 was selected to verify the repeatability of the experiment, and normal retina was selected for negative control. Cases with chromosome changes were grouped to analyze the correlation between chromosomal changes and pathological types of tumors. All data were analyzed by SPSS 15.0 software. Results: the 36 cases included 21 males and 15 females, aged 2373 years. All of them were Han nationality, 16 cases with left eye and 20 cases with right eye. The mean diameter of the base of the tumor was 12.5 mm, and the mean thickness of the tumor was 8.9 mm. There was no significant difference in sex ratio and age among the three groups. The pathology of 36 cases included spindle cell type (16 cases), mixed cell type (10 cases), epithelioid cell type (8 cases) and necrotic type (2 cases). The maximum diameter of the base of epithelioid cell type was larger than that of the other two groups, but the difference was not statistically significant. The average thickness of mixed cell type and epithelioid cell type was higher than that of fusiform cell type, and the difference was statistically significant (P0.05). The chromosomes cannot be detected. Among the other 34 cases, 13 cases had chromosome 3 deletion, 9 cases had chromosome 8 deletion and 7 cases had chromosome 6 deletion. Among them, 4 cases had simultaneous deletion of chromosome 3 and 8, 4 cases had simultaneous deletion of chromosome 3 and 6, and chromosome 18 was normal in 34 cases of simultaneous deletion of chromosome 8. No chromosomes were found in normal retina in the control group. Of the 13 cases with chromosome 3 deletion, 3 were spindle cell type, 5 were mixed cell type and 5 were epithelioid cell type. Of the 7 cases with chromosome 6 deletion, 1 was spindle cell type, 3 were mixed cell type and 3 were epithelioid cell type. In 9 cases with deletion of chromosome 8, spindle cell type was found in 1 case, mixed cell type in 4 cases, epithelioid cell type in 4 cases. There was no significant difference in thickness between chromosome 6 and chromosome 8. There was a significant correlation between the loss of chromosome 8 and the pathological type of tumor (P0.05). The chromosome changes in mixed cell type and epithelioid cell type were higher than those in fusiform cell type (P0.05). The deletion of multiple chromosomes was more common in mixed cell type and epithelioid cell type (P0.05). Conclusion: in choroidal melanoma, chromosome 3 and chromosome 8 are the most common, followed by chromosome 8 and chromosome 6. There was a significant correlation between chromosome changes and pathological types of tumors.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R739.7

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