胃癌组织中VEGFR2、HER2、TP的表达与其恶性程度的相关性分析

发布时间：2018-03-30 04:29

本文选题：胃癌　切入点：恶性程度　出处：《大连医科大学》2017年硕士论文

【摘要】：目的:探讨免疫组化标记物VEGFR2、HER2及TP在胃癌组织中的表达水平与胃癌恶性程度的关系,以及三者联合检测对胃癌恶性程度评估的意义和临床应用价值。方法:回顾性分析大连医科大学附属第二医院胃肠外科2015年1月至2016年10月收治的169例胃癌患者的免疫组化标记物VEGFR2、HER2、TP的检测结果及相关临床病理资料(年龄、性别、肿瘤大小、肿瘤部位、分化程度、浸润深度、TNM分期、有无区域淋巴结转移、有无远处转移、有无脉管及神经侵犯)。运用SPSS17.0软件系统进行统计分析,选用秩和检验(Mann-Whitney test和Kruskal-Wallis test)来分析VEGFR2、HER2、TP表达水平与患者临床病理资料间的关系;所涉及相关性分析均选用Spearman等级相关分析,根据统计分析结果来探讨以上三项免疫组化标记物的表达水平与胃癌恶性程度的关系,以及三者联合检测对胃癌恶性程度评估的意义及临床应用价值。结果:胃癌组织中VEGFR2的高表达与胃癌患者的浸润深度(p=0.013)、TNM分期(p=0.019)、区域淋巴结转移(p=0.007)、脉管侵犯(p=0.002)有关,并且VEGFR2的表达水平与浸润深度(r=0.217,p=0.005)及TNM分期成正相关(r=0.237,p=0.002);而与患者性别、年龄、肿瘤大小、肿瘤部位、分化程度及有无远处转移和神经侵犯无关(p0.05)。胃癌组织中HER2的高表达仅与胃癌组织的分化程度有关(p=0.001),且成负相关(r=-0.286,p0.001),而与患者的性别、年龄、肿瘤大小、肿瘤部位、浸润深度、TNM分期及有无区域淋巴结转移、远处转移和脉管、神经侵犯均无关(p0.05)。胃癌组织中TP的高表达与胃癌患者的浸润深度(p=0.016)、淋巴结转移(p=0.012)、TNM分期(p=0.010)、远处转移(p=0.019)有关,并且TP的表达水平与浸润深度(r=0.214,p=0.005)、TNM分期(r=0.196,p=0.011)成正相关;而与患者性别、年龄、肿瘤大小、肿瘤部位、分化程度及有无脉管和神经侵犯无关(p0.05)。VEGFR2与TP的表达呈正相关(r=0.200,p=0.009);而HER2与VEGFR2的表达,HER2与TP的表达均无显著相关性(p0.05)。结论:VEGFR2的高表达与胃癌浸润深度、TNM分期、淋巴结转移、脉管侵犯有关,可能是评价胃癌恶性程度重要指标,与胃癌恶性程度呈正相关。HER2的高表达与胃癌组织分化程度成负相关,表明HER2的表达具有选择性,HER2阳性的胃癌可能具有较低的恶性程度。TP的高表达与胃癌浸润深度、淋巴结转移、TNM分期、远处转移有关,可能成为评价胃癌恶性程度的指标之一,与胃癌恶性程度呈正相关。VEGFR2与TP的表达呈正相关;而HER2与VEGFR2、TP的表达无显著相关性,表明HER2可能不直接参与胃癌的血管生成,不会增加胃癌恶性程度;而VEGFR2、TP可能在胃癌血管生成及加重胃癌恶性程度方面具有协同作用。三者联合检测对胃癌的恶性程度评估具有重要价值,并对临床靶向药物及化疗药物的选择具有指导意义。
[Abstract]:Objective: to investigate the relationship between the expression of VEGF FR2HER2 and TP in gastric carcinoma and the malignant degree of gastric cancer. The significance and clinical value of combined detection in the evaluation of malignant degree of gastric cancer methods: a retrospective analysis of 169 patients with gastric cancer admitted from January 2015 to October 2016 in the second affiliated Hospital of Dalian Medical University. The immunohistochemical marker VEGFR2HER2TP and its clinicopathological data (age, age, age). Sex, tumor size, tumor location, differentiation degree, depth of invasion, TNM staging, regional lymph node metastasis, distant metastasis, vascular and nerve invasion were analyzed with SPSS17.0 software system. Mann-Whitney test and Kruskal-Wallis testwere used to analyze the relationship between the expression of VEGFR2HER2TP and the clinicopathological data of the patients, and Spearman rank correlation analysis was used to analyze the correlation. According to the results of statistical analysis, the relationship between the expression of the above three immunohistochemical markers and the malignant degree of gastric cancer was studied. Results: the high expression of VEGFR2 in gastric cancer was related to the depth of invasion of gastric cancer, the regional lymph node metastasis p0.007, and the vascular invasion of p0.002). The expression level of VEGFR2 was positively correlated with the depth of invasion (0.217p0. 005) and the TNM stage, and with sex, age, tumor size and tumor location. The high expression of HER2 in gastric cancer was only related to the differentiation degree of gastric cancer, and was negatively correlated with the sex, age, tumor size, tumor location, and negatively correlated with the patient's sex, age, tumor size, tumor location, and negative correlation with the degree of differentiation. TNM stage and regional lymph node metastasis, distant metastasis, vascular invasion and nerve invasion were not related to the expression of TP in gastric cancer. The high expression of TP was related to the depth of invasion of gastric cancer patients (p0.016), lymph node metastasis (p0.012), TNM staging (p0.010) and distant metastasis (p0.019). The expression level of TP was positively correlated with the depth of invasion (0.214p) and TNM stage (0.196 p0.011), but was positively correlated with the patient's sex, age, tumor size and tumor location. The expression of VEGF R2 and TP was positively correlated with the expression of TP, while the expression of HER2 and VEGFR2 had no significant correlation with the expression of TP. Conclusion the high expression of VEGFR2 is associated with the stage of invasion depth of gastric carcinoma, lymph node metastasis, and the expression of HER2 and TP is not significantly correlated with the degree of differentiation and the presence of vascular and nerve invasion. Vascular invasion may be an important index to evaluate the malignant degree of gastric cancer, and the high expression of HER2 is negatively correlated with the degree of differentiation of gastric cancer. The results suggest that the high expression of HER2 may be associated with the depth of invasion, lymph node metastasis and distant metastasis of gastric cancer, which may be one of the indicators to evaluate the malignant degree of gastric cancer. There was a positive correlation between VEGF R2 and TP expression in gastric cancer, but there was no significant correlation between HER2 and VEGF R2TP expression, indicating that HER2 might not directly participate in angiogenesis of gastric cancer and would not increase the malignant degree of gastric cancer. VEGFR2TP may play a synergistic role in angiogenesis and the degree of malignancy of gastric cancer. The combined detection of the three may be of great value in evaluating the malignancy of gastric cancer, and also of guiding significance in the selection of targeted drugs and chemotherapeutic drugs.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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