白介素-33在结直肠癌中表达及临床意义

发布时间：2018-01-11 08:24

  本文关键词：白介素-33在结直肠癌中表达及临床意义　出处：《苏州大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 白细胞介素-33 结直肠癌 临床意义

【摘要】：目的探讨结直肠癌组织中白介素-33(interleukin-33,IL-33)表达与临床特征关系,并分析其与患者预后关系。研究结直肠癌患者血清可溶性白介素-33(soluble interleukin-33,sIL-33)水平与临床特征关系,评价其对结直肠癌诊断意义。方法结直肠癌组织芯片中包含98例癌组织和80例癌旁组织。采用免疫组织化学染色法检测其中IL-33表达,采用卡方检验比较结直肠癌和癌旁组织中IL-33阳性表达比例差异,分析不同临床特征患者IL-33表达差异,采用Kaplan-Meier法分析IL-33表达与患者总生存期(Overall survival,OS)关系,并拟合Cox比例风险模型。收集121例结直肠癌患者术前血清与临床特征资料,并收集33例肠息肉患者和81例健康体检者作为对照。ELISA法检测血清中sIL-33水平,分析其与临床特征关系,采用ROC曲线、Logistic回归模型分析sIL-33、CEA和CA19-9三者单独或联合检测对结直肠癌诊断价值。结果结直肠癌组织中IL-33阳性表达率(38.78%)低于癌旁组织(63.75%),差异有统计学意义(P0.01)。IL-33表达与病理分级有关,随病理分级增加,阳性率逐渐降低(I、II和III级分别为66.67%、36.76%和20%,P=0.027)。Kaplan-Meier法分析表明IL-33阳性较阴性患者OS差异无统计学意义(log-rankχ2=0.3755,P=0.54)。多因素Cox比例风险模型表明,远处转移(HR=7.841,P=0.002)和较晚的TNM分期(HR=2.594,P=0.003)为结直肠癌独立预后因素。结直肠癌患者血清sIL-33含量172.44(108.08,321.57)pg/mL显著高于肠息肉组67.31(37.72,130.44)pg/mL和健康体检组71.73(36.80,85.53)pg/mL,差异有统计学意义(P0.01)。sIL-33水平与结直肠癌分化程度、肿瘤部位有关,差异有统计学意义(P0.01)。sIL-33、CEA和CA19-9三者联合检测的敏感性(80.99%)、准确率(86.38%)和ROC曲线下面积(0.9334)均比单独检测高,其特异性(92.11%)也处于较高水平,表明具有较好的诊断价值。结论结直肠癌患者组织中IL-33阳性表达率低于癌旁组织,且与病理分级有关。结直肠癌患者血清sIL-33含量显著高于对照组,并且与分化程度、肿瘤部位有关。sIL-33、CEA和CA19-9三者联合检测对结直肠癌具有较高辅助诊断价值,可作为潜在的血清生物标志物。
[Abstract]:Objective to investigate the relationship between interleukin-33 (IL-33) expression and clinical features in colorectal cancer. To study serum soluble interleukin-33 soluble interleukin-33 in patients with colorectal cancer. The level of sIL-33 was correlated with clinical features. Methods 98 cases of colorectal cancer and 80 cases of adjacent tissues were included in the tissue microarray. Immunohistochemical staining was used to detect the expression of IL-33. The difference of IL-33 positive expression in colorectal cancer and paracancerous tissues was compared by chi-square test, and the difference of IL-33 expression in patients with different clinical characteristics was analyzed. The relationship between the expression of IL-33 and the total survival time of patients was analyzed by Kaplan-Meier method. Cox proportional risk model was fitted to collect data of serum and clinical features of 121 patients with colorectal cancer before operation. The serum sIL-33 levels were measured by Elisa in 33 patients with intestinal polyps and 81 healthy controls. The relationship between the serum levels and clinical characteristics was analyzed and ROC curve was used. Logistic regression model was used to analyze sIL-33. Results the positive expression rate of IL-33 in colorectal cancer tissues was 38.78), which was lower than that in paracancerous tissues (63.75%). . The expression of IL-33 was related to the pathological grade. With the increase of pathological grade, the positive rate decreased gradually, and the positive rate was 66.67% in grade 鈪，

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