梗阻性黄疸患者血清、组织中MFG-E8的表达与良恶性的相关性研究

发布时间：2018-05-22 14:23

本文选题：MFG-E8 + 梗阻性黄疸　；参考：《山西医科大学》2016年硕士论文

【摘要】：目的:1.观察由肝外胆管结石引起的良性梗阻性黄疸与胆管癌引起的恶性梗阻性黄疸患者外周血清中MFG-E8蛋白的表达水平;2.探讨MFG-E8蛋白在良恶性梗阻性黄疸鉴别中的作用及与胆管癌临床病理特征的相关性。方法:1.分组:随机选取确诊为单纯性肝外胆管结石引起的梗阻性黄疸的患者28例,作为良性梗阻性黄疸组(B组),入选者无发热、胆管炎等其他病史;随机选取确诊为胆管癌的梗阻性黄疸患者21例,作为恶性梗阻性黄疸组(C组),入选者以无痛性梗阻性黄疸入院,无其他病史;选择健康志愿者25例作为对照组(A组)。2.采集:(1)采集对照组(A组)清晨空腹静脉血,及良、恶性梗阻性黄疸组(B、C组)患者入院第一天清晨空腹静脉血,离心后取上清液,采用双抗夹心酶联免疫吸附法(ELISA)测量MFG-E8含量;(2)术中收集恶性梗阻性黄疸组(C组)患者的肿瘤组织,实验室行肿瘤组织行免疫组化染色;(3)收集恶性组患者的临床病理特征资料。结果:1.与对照组(A组)相比,良性梗阻性黄疸组(B组)外周血清中MFG-E8蛋白含量明显降低(P0.05);恶性梗阻性黄疸组(C组)外周血清中MFG-E8蛋白含量显著升高(P0.05);良、恶性梗阻性黄疸两组(B、C组)外周血清中MFG-E8蛋白水平存在显著性差异(P0.05),恶性组明显高于良性组。2.胆管癌肿瘤组织中MFG-E8的表达显著高于周围组织;胆管癌患者外周血及肿瘤组织中,MFG-E8蛋白水平在临床Ⅰ、Ⅱ期明显低于Ⅲ期、Ⅳ期;分化程度高的组低于中、分化组;无转移组明显低于转移组。结论:1、胆总管结石引起的良性梗阻性黄疸患者外周血清中人乳脂球表皮生长因子Ⅷ的水平明显降低,会使得人乳脂球表皮生长因子Ⅷ介导的细胞吞噬作用减弱,大量凋亡细胞堆积,这可能是产生多器官功能损害的机制之一。2、胆管癌引起的恶性梗阻性黄疸患者外周血清及肿瘤组织中人乳脂球表皮生长因子Ⅷ过度表达,且胆管癌组织中人乳脂球表皮生长因子Ⅷ的表达与肿瘤的临床分期、分化程度、转移相关,可能是与人乳脂球表皮生长因子Ⅷ促进肿瘤的生长、浸润和转移有关。人乳脂球表皮生长因子Ⅷ可作为胆管癌诊断、预后的一项指标。3、外周血清中人乳脂球表皮生长因子Ⅷ的表达水平可作为良恶性梗阻阻塞性黄疸鉴别的一项指标。
[Abstract]:Objective: 1. to observe the expression level of MFG-E8 protein in peripheral serum of patients with benign obstructive jaundice caused by extrahepatic bile duct stones and malignant obstructive jaundice caused by cholangiocarcinoma; 2. to explore the role of MFG-E8 protein in the identification of benign and malignant obstructive jaundice and the correlation with the clinicopathological features of bile duct carcinoma. Methods: 1. groups: random selection. 28 cases of obstructive jaundice caused by simple extrahepatic bile duct stones were diagnosed as benign obstructive jaundice group (group B), and other patients had no fever and cholangitis. 21 cases of obstructive jaundice diagnosed as cholangiocarcinoma were randomly selected as malignant obstructive jaundice group (group C), and the patients were admitted to the hospital with painless obstructive jaundice. He selected 25 healthy volunteers as the control group (group A).2. collection: (1) collect the early morning venous blood from the control group (group A), and the benign, malignant obstructive jaundice group (B, C group) the first day morning empty abdominal vein blood, then take the supernatant after centrifugation, and use the double anti sandwich enzyme-linked immunosorbent assay (ELISA) to measure the MFG-E8 content; (2) the collection was collected in the operation. The tumor tissues of the malignant obstructive jaundice group (group C) were treated with immunohistochemical staining in the laboratory, and (3) to collect the clinicopathological features of the patients in the malignant group. Results 1. compared with the control group (group A), the content of MFG-E8 protein in the peripheral serum of the benign obstructive jaundice group (group B) was significantly decreased (P0.05) and the malignant obstructive jaundice group (group C). The content of MFG-E8 protein in peripheral serum increased significantly (P0.05), and there was a significant difference in the level of MFG-E8 protein in peripheral serum of two groups (B, C) in benign and malignant obstructive jaundice (P0.05). The expression of MFG-E8 in malignant group was significantly higher than that in benign group of.2. cholangiocarcinoma, and the expression of MFG-E8 was significantly higher than that in peripheral tissue; MFG-E in peripheral blood and tumor tissues of cholangiocarcinoma patients, MFG-E The level of 8 protein in clinical I, stage II was obviously lower than stage III and stage IV, and the group with high differentiation was lower than that in the middle, differentiation group; no metastasis group was significantly lower than that of the transfer group. Conclusion: 1, the level of human cream epidermal growth factor VIII in the peripheral serum of patients with benign obstructive jaundice caused by choledocholithiasis would reduce the growth of human milk fat epidermis. Zi mediated cell phagocytosis is weakened and a large number of apoptotic cells accumulate. This may be one of the mechanisms that produce multiple organ dysfunction,.2. The excessive expression of the human creamball epidermal growth factor VIII in the peripheral serum and tumor tissues of the patients with malignant obstructive jaundice caused by cholangiocarcinoma and the human creamball epidermal growth factor VIII in the bile duct carcinoma tissue. The expression is related to the clinical stage, degree of differentiation and metastasis of the tumor. It may be related to the growth, infiltration and metastasis of human milk fat globule epidermal growth factor VIII. Human creamy epidermal growth factor VIII can be used as an indicator of the diagnosis of cholangiocarcinoma, the prognosis is.3, and the expression level of human milk fat globule epidermal growth factor VIII in peripheral serum can be found. As an indicator of differential diagnosis between benign and malignant obstructive jaundice.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.8;R575

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