结直肠腺癌中HER2、GEFR、S100A14蛋白的表达及其临床意义

发布时间：2018-03-30 21:11

本文选题：结直肠腺癌　切入点：HER2　出处：《河北医科大学》2015年硕士论文

【摘要】：目的:通过检测结直肠腺癌、腺瘤以及癌旁无瘤粘膜组织中人类表皮生长因子受体2(human epidermalgrowth factor receptor-2,HER2)、表皮生长因子受体(epidermal growth factor receptor,EGFR)、S100A14蛋白的表达变化,探讨三种蛋白表达的表达变化与结直肠腺癌发生的关系;分析结直肠腺癌中HER2、EGFR、S100A14的表达与临床病理指标的相关性,探讨三种蛋白在结直肠腺癌发展中的作用。旨在探讨在结直肠腺癌发生发展过程中HER2、EGFR、S100A14的作用及可能机制。方法:选取2012年6月至2013年8月在唐山市工人医院行结直肠腺癌手术切除的标本进行研究。其中腺癌120例,同时选取对应癌旁无瘤粘膜组织(距离大于2cm)84例。另外选取手术切除的结直肠腺瘤84例。用免疫组化法(SP法)检测HER2、EGFR、S100A14在不同组织中的表达。用SPSS17.0统计学软件对数据作出统计学分析。结果:1 HER2蛋白在结直肠腺癌、腺瘤以及癌旁无瘤粘膜组织中的阳性率分别为70.00%、14.28%、11.90%,结直肠腺癌组织中HER2蛋白的表达阳性率远远高于腺瘤和癌旁无瘤粘膜组织中HER2蛋白的阳性率,其差别均具有统计学意义(分别为X2=61.564,P=0.000;X2=67.120,P=0.000),腺瘤组织和癌旁无瘤粘膜组织之间阳性率的差异无统计学意义(X2=0.209,P=0.647)。2在结直肠腺癌组织中,HER2蛋白在中、高分化组的表达阳性率为57.57%,在低分化组表达阳性率为85.18%,两组差异具有统计学意义(X2=10.781,P=0.001);伴有淋巴结转移的结直肠腺癌组织中,HER2蛋白的表达阳性率为88.89%,而无淋巴结转移的结直肠腺癌组织中,HER2蛋白的表达阳性率为54.54%,其差别有统计学意义(X2=16.681,P=0.000);在肿瘤未浸润至浆膜和浸润至(或超过)浆膜的结直肠腺癌组织中的HER2蛋白的表达分别为59.01%和81.35%,两组差别有统计学意义(X2=7.127,P=0.008);在TNM分期Ⅰ+Ⅱ期和Ⅲ+Ⅳ期中的表达阳性率分别为60.31%和80.70%,两组差别有统计学意义(X2=5.921,P=0.015);而HER2蛋白在不同年龄、不同性别、不同肿瘤部位的结直肠腺癌比较中,其表达差别无统计学意义(P0.05)。3 EGFR蛋白在结直肠腺癌、腺瘤以及癌旁无瘤粘膜组织中的表达阳性率分别为65.83%、57.14%、35.71%,结直肠腺癌组织中EGFR蛋白的表达阳性率远远高于癌旁无瘤粘膜组织中EGFR蛋白的阳性率,其差别具有统计学意义(X2=18.015,P=0.000),腺瘤组织中阳性率高于癌旁无瘤粘膜组织中的阳性率,其差别有统计学意义(X2=7.754,P=0.005),腺癌组织和腺瘤组织之间阳性率的差异无统计学意义(X2=1.588,P=0.208)。4结直肠腺癌组织中,EGFR蛋白在中、高分化组的表达阳性率为51.56%,低分化组的表达阳性率为82.14%,两组差异具有统计学意义(X2=12.417,P=0.000);伴有淋巴结转移的腺癌组织中,EGFR蛋白的阳性率(87.03%)明显高于无淋巴结转移的腺癌组织中EGFR蛋白的阳性率(51.51%),其差别有统计学意义(X2=17.083,P=0.000);在肿瘤未浸润至浆膜和浸润至(或超过)浆膜的结直肠腺癌组织中的EGFR蛋白的阳性率分别为50.81%和81.35%,两组差别有统计学意义(X2=12.433,P=0.000);在TNM分期Ⅰ+Ⅱ期和Ⅲ+Ⅳ期中的阳性率分别为57.14%和75.43%,两组差别有统计学意义(X2=4.453,P=0.035);而EGFR蛋白的表达在不同年龄、不同性别、不同肿瘤部位的腺癌中,其表达差别无统计学意义(P0.05)。5 S100A14蛋白结直肠腺癌、腺瘤以及癌旁无瘤粘膜组织中的阳性率分别是66.67%、66.67%、45.24%,结直肠腺癌组织中S100A14蛋白的表达阳性率远远高于癌旁无瘤粘膜组织中S100A14蛋白的阳性率,其差别具有统计学意义(X2=9.305,P=0.002),腺瘤组织中阳性率高于癌旁无瘤粘膜组织中的阳性率,其差别有统计学意义(X2=7.825,P=0.005),腺癌组织和腺瘤组织之间阳性率的差异无统计学意义(X2=0.000,P=1.000)。6在结直肠腺癌组织中S100A14蛋白的中、高分化组的阳性率为50%,低分化组的阳性率为85.17%,两组差别具有统计学意义(X2=17.143,P=0.000);伴有淋巴结转移的结直肠腺癌组织中,S100A14蛋白的阳性率为81.48%,而无发生淋巴结转移的结直肠腺癌组织中,S100A14蛋白的阳性率为54.54%,其差别有统计学意义(X2=9.796,P=0.002);在肿瘤未浸润至浆膜和浸润至(或超过)浆膜的结直肠腺癌组织中的S100A14蛋白的阳性率分别为54.09%和79.66%,两组差别有统计学意义(X2=8.819,P=0.003);在TNM分期Ⅰ+Ⅱ期和Ⅲ+Ⅳ期中的阳性率分别为50.79%和84.21%,两组差别有统计学意义(X2=15.038,P=0.000);S100A14蛋白的表达在不同年龄、不同性别、不同肿瘤部位的腺癌中,其表达差别无统计学意义(P0.05)。7经SPSS17.0软件的spearman检验分析显示,结直肠腺癌组织中的HER2和EGFR呈正相关(r=0.28,P=0.002),HER2和S100A14呈正相关(r=0.309,P=0.001),EGFR和S100A14呈正相关(r=0.564,P=0.000)。结论:1 HER2、EGFR、S100A14蛋白在结直肠腺癌中过度表达,明显高于无瘤粘膜,表明三者可能参与癌变过程。2 HER2、EGFR、S100A14蛋白的高表达与分化差、淋巴结转移、浸润深及TNMⅢ+Ⅳ相关,表明HER2、EGFR、S100A14可能与结直肠腺癌的恶性生物学行为有关。3在结直肠腺癌中HER2、EGFR、S100A14蛋白的表达呈两两相关,表明三者在结直肠癌发生发展中的作用通路可能存在交互作用。
[Abstract]:Objective: through the detection of colorectal adenocarcinoma, adenoma and adjacent non tumor tissues of human epidermal growth factor receptor 2 (human epidermalgrowth factor receptor-2, HER2), epidermal growth factor receptor (epidermal growth factor receptor, EGFR), S100A14 protein expression, to explore the relationship between the expression of three kinds of protein expression and colorectal adenocarcinoma cancer; analysis of HER2, EGFR in colorectal adenocarcinoma and the correlation between S100A14 expression and clinicopathological parameters, to investigate the effect of three kinds of protein in colorectal adenocarcinoma development. To investigate the direct HER2, in the process of the development of intestinal adenocarcinoma in EGFR, the role of S100A14 and its possible mechanism. Methods: from June 2012 to August 2013 study in Tangshan City workers' hospital for colorectal cancer resection specimens including 120 cases of adenocarcinoma, and select the corresponding adjacent non tumor tissues (distance greater than 2cm) in 84 cases. In addition to select surgical resection in 84 cases of colorectal adenoma. Using immunohistochemical method (SP method) to detect HER2, EGFR, S100A14 expression in different tissues. Statistical analysis of data by SPSS17.0 statistical software. Results: 1 HER2 protein in colorectal adenocarcinoma, adenoma and adjacent non tumor tissues. The positive rate of were 70%, 14.28%, 11.90%, the positive expression rate of HER2 protein in colorectal adenocarcinoma tissues is much higher than the positive rate of adenomas and carcinomas without HER2 protein in tumor tissues, the difference was statistically significant (X2=61.564, P=0.000; X2=67.120, P=0.000), no statistically significant difference between adenomas and carcinomas without between the positive rate of tumor tissue (X2=0.209, P=0.647).2 in colorectal cancer tissues, HER2 protein positive expression rate in high differentiation group was 57.57%, in the low differentiation group positive expression rate was 85.18%, with the difference between the two groups Statistical significance (X2=10.781, P=0.001); lymph node metastasis in colorectal adenocarcinoma tissues, the positive expression rate of HER2 protein was 88.89%, and no lymph node metastasis in colorectal adenocarcinoma tissues, the positive expression rate of HER2 protein was 54.54%, the difference was statistically significant (X2=16.681, P=0.000); in without tumor infiltration to serosa and infiltrating into the serosa (or more than) expression in colorectal adenocarcinoma tissues of HER2 protein were 59.01% and 81.35%, there was significant difference between the two groups (X2=7.127, P=0.008); the positive expression rate of TNM in stage I + II and III + IV in 60.31% and 80.70% respectively, there was statistical significant difference between the two groups (X2=5.921, P=0.015); and HER2 protein in different age, different gender, different parts of the tumor in colorectal adenocarcinoma, the expression had no significant difference (P0.05) of.3 EGFR protein in colorectal adenocarcinoma, adenoma and adjacent non tumor The positive expression rate of mucosa were 65.83%, 57.14%, 35.71%, the positive expression rate of EGFR protein in colorectal adenocarcinoma tissues is much higher than the positive rate of EGFR protein in tumor adjacent non cancer tissues, the difference was statistically significant (X2=18.015, P=0.000), the positive rate of adenoma tissues than adjacent non tumor positive rate mucosal tissues, the difference was statistically significant (X2=7.754, P=0.005), there was no significant difference between adenocarcinoma and adenoma tissue positive rate (X2=1.588, P=0.208).4 in colorectal adenocarcinoma tissues, EGFR protein positive expression rate in high differentiation group was 51.56%, the positive expression rate of low differentiation group 82.14%, with significant difference between two groups (X2=12.417, P=0.000); lymph node metastasis of adenocarcinoma, the positive rate of EGFR protein (87.03%) was significantly higher than the positive rate of EGFR protein and lymph node metastasis in adenocarcinoma (5 1.51%), the difference was statistically significant (X2=17.083, P=0.000); in tumor infiltrating serosa and invasion to serosa (or more than) the positive rate of the colorectal adenocarcinoma tissues of EGFR protein were 50.81% and 81.35%, there was significant difference between the two groups (X2=12.433, P= 0); the positive rate in TNM stage I + II and III + IV in 57.14% and 75.43% respectively, there was significant difference between the two groups (X2=4.453, P=0.035); and the expression of EGFR protein in different age, different gender, different parts of the tumor in adenocarcinoma, the expression of the difference was no statistical significance (P0.05) of.5 S100A14 protein in colorectal adenocarcinoma, adenoma and adjacent non tumor tissues and the positive rate were 66.67%, 66.67%, 45.24%, the positive expression rate of S100A14 protein in colorectal adenocarcinoma tissues is much higher than the positive rate of S100A14 protein in tumor adjacent non cancer tissues, the difference was statistically significant (X2 =9.305, P=0.002), the positive rate of adenoma tissues than adjacent non tumor tissues the positive rate, the difference was statistically significant (X2=7.825, P=0.005), there was no significant difference between adenocarcinoma and adenoma tissue positive rate (X2=0.000, P=1.000).6 S100A14 in colorectal adenocarcinoma protein. The positive rate of high differentiation group was 50%, the positive rate of low differentiation group was 85.17%, statistically significant difference between the two groups (X2=17.143, P=0.000); lymph node metastasis in colorectal adenocarcinoma tissues, the positive rate of S100A14 protein was 81.48%, and no lymph node metastasis in colorectal adenocarcinoma tissues, the positive rate of the S100A14 protein was 54.54%, the difference was statistically significant (X2=9.796, P=0.002); in tumor infiltrating serosa and invasion to serosa (or more than) the positive rate of the colorectal adenocarcinoma tissues of S100A14 protein were 54.09% and 79.66%, the two groups The difference was statistically significant (X2=8.819, P=0.003); the positive rate of TNM in stage I + II and III + IV in 50.79% and 84.21% respectively, there was significant difference between the two groups (X2=15.038, P=0.000); the expression of S100A14 protein in different age, different gender, different parts of the tumor in adenocarcinoma, the there was no significant difference between the expression of.7 (P0.05) by Spearman test SPSS17.0 software analysis showed that in colorectal adenocarcinoma tissues related to HER2 and EGFR (r=0.28, P=0.002), positive HER2 and S100A14 was positively correlated (r=0.309, P=0.001), EGFR and S100A14 were positively correlated (r=0.564, P=0.000). Conclusion: 1 HER2, EGFR. Over expression of S100A14 protein in colorectal adenocarcinoma was significantly higher than that in non tumor mucosa, Biao Mingsan, who may be involved in the carcinogenesis of.2, HER2, EGFR, S100A14 protein expression and differentiation, lymph node metastasis, invasion depth and TNM III + IV, EGFR, showed that HER2, S100A14 and The malignant biological behavior of colorectal adenocarcinoma is related to.3. The expression of HER2, EGFR and S100A14 protein in colorectal adenocarcinoma is 22, which indicates that there may be interaction between the three pathways in the development and progression of colorectal cancer.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.34

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