促泌素与嗜铬粒蛋白A在胃肠胰神经内分泌肿瘤中的表达及临床意义

发布时间：2018-04-29 08:46

本文选题：促泌素 + 嗜铬粒蛋白A　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:通过检测促泌素(SCGN)和嗜铬粒蛋白A(Cg A)在胃肠胰神经内分泌肿瘤(GEP-NEN)石蜡包埋组织中的表达,探讨SCGN在GEP-NEN中的临床意义以及作为神经内分泌肿瘤标志物用于早期诊断的可能性。方法:收集胃肠胰神经内分泌肿瘤共36例。包括胃神经内分泌肿瘤(NEN)10例,肠道NEN10例(9例直肠,1例小肠),胰腺NEN16例。按照病理分级包括G1级14例,G2级10例,G3级12例。将每1例石蜡包埋组织留取3张切片,分别进行HE染色重新确认NEN诊断、SCGN和Cg A的免疫组织化学染色。用SPSS统计学软件比较SCGN与Cg A的阳性表达率及诊断胃肠胰神经内分泌肿瘤的敏感性,分析在不同的发病部位、肿瘤的不同分级中的表达情况以及与肿瘤的各项临床特征的关系。结果:(1)36例GEP-NEN患者的石蜡包埋组织中SCGN阳性表达率为88.9%(32/36),其中15例弱阳性(+),14例阳性(++),3例强阳性(+++)。Cg A阳性表达率为66.7%(24/36),其中5例弱阳性(+),13例阳性(++),6例强阳性(+++)。SCGN的阳性表达率较Cg A高(P0.05)。SCGN检测GEP-NEN的敏感性(88.9%)高于Cg A的敏感性(66.7%)(P0.05)。(2)在胃和胰腺NEN中,SCGN与Cg A的表达差异无统计学意义(P0.05),在肠道NEN中SCGN的表达明显比Cg A高(P0.05)。SCGN的表达在胃、肠道、胰腺不同部位之间比较无统计学差异(P0.05)。而Cg A在不同部位中的表达有显著性差异(P0.05),Cg A在肠道NEN中均不表达,组间两两比较,Cg A在肠NEN中的表达与胃或胰腺NEN组织中表达差异有意义(P0.017),在胃NEN与胰腺NEN中的差异无意义(P0.017)。(3)在GEP-NEN的3个病理分级中,SCGN与Cg A的表达差异无统计学意义(P0.05)。SCGN在G1级、G2级、G3级的肿瘤组织中的表达差异具有统计学意义(P0.05),组间两两比较,G1级与G2级、G2级与G3级肿瘤组织中SCGN的表达差异无统计学意义(P0.017),而SCGN在G3级肿瘤组织中的表达较G1级降低,差异有统计学意义(P0.017)。Cg A在GEP-NEN的不同的病理分级中表达无明显统计学差异(P0.05)。(4)SCGN在不同的性别、年龄以及是否伴有神经侵犯或脉管癌栓的肿瘤中的表达均无明显统计学差异(P0.05),在最大径2cm或2cm以上以及伴有淋巴转移的肿瘤中SCGN的表达水平降低,差异有统计学意义(P0.05)。Cg A在GEP-NEN的不同的临床特征中均无显著性差异(P0.05)。结论:在GEP-NEN中SCGN的阳性表达率较Cg A阳性表达率高;SCGN在胃、肠道、胰腺的NEN中均表达良好,与Cg A联合有助于提高检出率;SCGN在G3级GEP-NEN中的表达水平较G1级明显降低,Cg A则无明显差异;SCGN在直径2cm或2cm以上、伴有淋巴转移的GEP-NEN中表达水平下降;SCGN可作为神经内分泌肿瘤标志物应用于临床诊断,且具有用于早期诊断及预后判断的潜质。
[Abstract]:Objective: to detect the expression of secretin and chromaffin A(Cg A in paraffin-embedded tissues of gastrointestinal and pancreatic neuroendocrine tumors (GEP-NEN). To explore the clinical significance of SCGN in GEP-NEN and the possibility of early diagnosis as neuroendocrine tumor markers. Methods: 36 cases of gastrointestinal and pancreatic neuroendocrine tumors were collected. There were 10 cases of gastric neuroendocrine neoplasms, 9 cases of intestinal NEN10, 1 case of small intestine and 1 case of pancreatic NEN16. According to the pathological grading, 14 cases of G 1 grade and 10 cases of G 2 grade were classified as G 3 grade 12 cases. Three sections were taken from each paraffin embedded tissue and the immunohistochemical staining of SCGN and CG A was reconfirmed by HE staining. The positive expression rate of SCGN and CG A and the sensitivity of diagnosis of gastrointestinal and pancreatic neuroendocrine tumors were compared by SPSS software. Results the positive expression rate of SCGN in paraffin-embedded tissues of 36 patients with GEP-NEN was 88.9 / 36, of which 15 were weak (14 / 36). There was no significant difference in the expression of SCGN between gastric and pancreatic NEN (P 0.05U. SCGN was significantly higher than that of CG A in detecting GEP-NEN (88. 9%) than that of CG A (66. 7%). The expression of SCGN in intestinal NEN was significantly higher than that of CG A (P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05), but the expression of SCGN in intestinal NEN was significantly higher than that in intestinal NEN (P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05, P 0. 05). The expression of CGA, P0.05, SCGN was found in the stomach. There was no significant difference between different parts of intestine and pancreas (P 0.05). However, there was a significant difference in the expression of CG A in different parts of the intestine. No significant difference was found in the expression of CPG A in intestinal NEN. Comparison between two groups in the expression of CGA in intestinal NEN and gastric or pancreatic NEN tissues, there was no significant difference in the expression of CGA between gastric NEN and pancreatic NEN (P0.017. 3) in three pathological grades of GEP-NEN, there was no significant difference in the expression of CGN and CG A in the three pathological grades of GEP-NEN. There was a significant difference in the expression of SCGN between G 1 group and G 2 grade G 2 and G 3 grade tumor tissues. There was no significant difference in the expression of SCGN between G 1 grade and G 2 grade G 2 and G 3 grade tumor tissues, while the expression of SCGN in G 3 grade tumor tissues had no significant difference (P 0.017%). The expression level in the tissue was lower than that in the G1 level. There was no significant difference in the expression of P0.017A in different pathological grades of GEP-NEN. There was no significant difference in age and the expression of SCGN in tumors with or without nerve invasion or vascular tumor thrombus. The expression level of SCGN was decreased in tumors with maximum diameter 2cm or 2cm or with lymphatic metastasis. There was no significant difference in the clinical characteristics of GEP-NEN. Conclusion: the positive expression rate of SCGN in GEP-NEN is higher than that in CG A. The positive expression of SCGN in gastric, intestinal and pancreatic NEN is good. In combination with CG A, the expression of SCGN in G3 GEP-NEN was significantly lower than that in G1 grade. There was no significant difference in SCGN over diameter 2cm or 2cm. GEP-NEN with lymphatic metastasis can be used as a neuroendocrine tumor marker for clinical diagnosis and has the potential for early diagnosis and prognostic judgment.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735

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