c-kit、PTEN在胸腺上皮肿瘤中的表达及其意义

发布时间：2018-05-30 12:47

本文选题：胸腺瘤 + 胸腺癌　；参考：《河北医科大学》2016年硕士论文

【摘要】：背景:胸腺上皮肿瘤发病率低,病程发展缓慢,病理类型复杂,分类方法繁多,既有显微镜下复杂的组织结构,病理与预后又不统一,而且临床上有关的前瞻性随机对照的实验研究很少,导致临床医师对胸腺瘤认识相对不足,对其合理的病理分类及治疗模式存在争议。目的:研究c-kit、PTEN在胸腺上皮肿瘤中的表达情况,探讨两者与胸腺上皮肿瘤的病理类型、临床分期及是否合并重症肌无力(MG)的关系。方法:收集经手术切除且病理证实为胸腺增生、胸腺瘤及胸腺癌的病例,所有患者均未经术前化疗或放疗。记录每个胸腺上皮肿瘤患者的病理分型、临床分期及是否合并重症肌无力等情况。应用免疫组织化学方法(S-P法)检测14例胸腺增生、60例胸腺瘤、12例胸腺癌的c-kit、PTEN表达情况,所得结果应用SPSS19.0进行统计分析。结果:1 c-kit在胸腺增生、胸腺瘤、胸腺癌三组中的阳性表达率依次为7.1%,13.3%,66.7%,呈逐渐增加趋势,且之间有显著性差异(P0.05);c-kit在非侵袭性胸腺瘤患者(A型+AB型)中阳性表达率为9.4%,这低于侵袭性胸腺瘤患者(B1型+B2型+B3型)中的阳性表达率17.9%,差异无统计学意义(P=0.335);c-kit在Masaoka分期中I期、II期、III期、IV期阳性表达率依次为12.5%、13.3%、15.4%、12.5%,之间无显著性差异(P=0.998);c-kit在合并MG的胸腺瘤中的阳性表达率及未合并MG的胸腺瘤中的阳性表达率依次为13.5%,13.0%,二者之间无显著性差异(P=0.985)。2 PTEN在胸腺增生、胸腺瘤、胸腺癌三组的阳性表达率依次为85.7%、55.0%、16.7%,呈逐步降低的趋势,三者之间差异有统计学意义(P0.05);PTEN在非侵袭性胸腺瘤患者(A型+AB型)中的阳性表达率为71.9%,明显高于侵袭性胸腺瘤患者(B1型+B2型+B3型)中的阳性表达率35.7%,两者的差异有统计学意义(P0.05);PTEN在Masaoka分期中I期、II期、III期、IV期的阳性表达率分别为83.3%、53.3%、30.8%、12.5%,呈逐步降低的趋势,四者之间存在显著性差异(P0.05);PTEN在合并MG与未合并MG的胸腺瘤中的阳性表达率依次为54.1%、60.9%,两者之间无显著性差异(P=0.604)。结论:1 c-kit蛋白表达与胸腺病理分型存在正相关,与胸腺瘤的侵袭性关系不明显,表明c-kit是一个鉴别胸腺瘤和胸腺癌的很好的分子标记。2 PTEN表达与胸腺病理类型及Masaoka分期均呈明显负相关,说明PTEN不仅有利于帮助胸腺瘤、胸腺癌的诊断,而且可为胸腺瘤的侵袭性诊断提供依据。3 c-kit和PTEN在胸腺上皮肿瘤的发生、进展中起一定作用,检测它们有助于综合评估及指导治疗。c-kit和PTEN在胸腺瘤中的表达与是否合并重症肌无力无关。
[Abstract]:Background: the incidence of thymic epithelial tumors is low, the course of disease is slow, the pathological types are complex, the classification methods are various, there are complicated histological structures under microscope, and the pathology and prognosis are not unified. Moreover, there are few prospective randomized controlled clinical studies, which leads to the lack of understanding of thymoma, and the reasonable pathological classification and treatment mode of thymoma are controversial. Objective: to investigate the expression of c-kittene PTEN in thymic epithelial tumors and its relationship with the pathological types, clinical stages and myasthenia gravis (MG). Methods: all patients with thymic hyperplasia, thymoma and thymic carcinoma confirmed by surgery and pathology were not treated with chemotherapy or radiotherapy before operation. The pathological classification, clinical stage and myasthenia gravis were recorded for each thymic epithelial tumor. The expression of c-kitt PTEN in 14 cases of thymic hyperplasia and 12 cases of thymic carcinoma was detected by immunohistochemical method (S-P method). The results were statistically analyzed by SPSS19.0. Results the positive expression rate of c-kit in the three groups of thymic hyperplasia, thymoma and thymic carcinoma was 7.1 and 13.36.7respectively. The positive expression rate of c-kit in non-invasive thymoma patients was 9.4, which was lower than that in invasive thymoma patients with B _ 1 type B _ 2 B _ 3). There was no significant difference between them. The positive expression rate of c-kit in Masaoka stage I, stage II, stage III and stage IV was 12.5T, 13.3C and 15.4T, respectively. There was no significant difference between the two groups. There was no significant difference in the positive expression of c-kit in thymoma with MG, and the positive expression rate of c-kit in thymoma without MG was 13.5T and 13.0T, respectively. The positive expression rate of c-kit in thymoma with MG and without MG was 13.5T and 13.0T, respectively. There was no significant difference between the two groups in the thymus hyperplasia, and there was no significant difference between them. The positive expression rates of thymoma and thymic carcinoma were 85.7% and 55.0%, respectively. The positive expression rate of P0.05PTEN in non-invasive thymoma patients was 71.9, which was significantly higher than that in invasive thymoma patients with type B1 B2 B3). The positive expression rates of P0.05 / PTEN in Masaoka stage I / II / III / IV were 83.3 / 53.3and 30.8 / 12.5respectively, which showed a trend of gradual decrease. There was significant difference among the four groups. The positive expression rate of P0.05 and PTEN in thymoma with and without MG was 54.1 and 60.9, respectively. There was no significant difference between the two groups (P = 0.604). Conclusion there is a positive correlation between the expression of c-kit protein and the pathological type of thymus, but there is no significant relationship between the expression of c-kit protein and the invasiveness of thymoma. The results indicate that c-kit is a good molecular marker for differentiating thymoma from thymic carcinoma. The expression of 2. 2 PTEN is negatively correlated with the pathological type of thymus and Masaoka stage, which indicates that PTEN is not only helpful for the diagnosis of thymoma and thymic carcinoma, but also helpful to the diagnosis of thymoma. Moreover, it can provide evidence for invasive diagnosis of thymoma. 3. 3 c-kit and PTEN may play a role in the occurrence and progression of thymoma. Detecting the expression of. C-kit and PTEN in thymoma is helpful to evaluate and guide the treatment of thymoma. There is no correlation between the expression of c-kit and PTEN in thymoma.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R736.3

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