食管鳞癌患者外周血CTTNmRNA的表达及其临床意义

发布时间：2018-05-31 13:44

本文选题：食管鳞癌微转移 + CTTNmRNA　；参考：《苏州大学》2015年硕士论文

【摘要】：目的:初步探索食管鳞癌患者外周血中CTTNm RNA的表达,探讨其作为食管鳞癌微转移标志物的可行性和其表达的高低对食管鳞癌患者预后的影响。方法:用实时荧光定量逆转录聚合酶链式反应的方法联合检测40例食管鳞癌患者手术切除的肿瘤标本和食管残端CTTNm RNA的表达并比较二者的区别,检测40例健康献血员的外周血标本CTTNm RNA的表达得出正常人群的表达范围,以此为标准检测40例食管鳞癌患者术前外周血标本是否存在CTTNRm RNA的高表达。在17个月内随访观察这40例食管鳞癌患者的生存状态。结果:1.CTTNm RNA在食管鳞癌组织中的表达量均明显高于食管残端组织(P0.05)。2.25例患者的外周血标本检测出CTTNm RNA的高表达,阳性率为62.5%。3.食管鳞癌患者外周血CTTNm RNA阳性表达的患者,在对应的癌组织中都检测到CTTNm RNA呈高表达(P0.05),食管癌患者外周血与对应癌组织中CTTNm RNA表达具有一致性。4.食管鳞癌患者外周血CTTNm RNA表达与淋巴结转移、浸润程度、病理分期及预后密切相关(P0.05);与性别、年龄、烟酒史、肿瘤大小、细胞分化程度等无相关性(P0.05)。5.40例食管鳞癌患者均随访至2015年4月,失访4例,死亡17例,存活19例,随访率90.0%,17例死亡患者中位生存期4.5个月,40例患者中位随访时间13个月,1年生存率62.5%。外周血CTTNm RNA阳性病人死亡15例(15/25,60.0%)。单因素COX回归分析结果显示肿瘤位置(RR=2.783),肿瘤大小(RR=2.727),癌细胞分化程度(RR=3.649),浸润深度(RR=3.270),淋巴结转移(RR=24.090),远处转移(RR=8.371),病理分期(RR=4.135),CTTNm RNA(RR=5.660)为预后危险因素,而年龄,性别,吸烟及饮酒等均无统计学意义。多因素COX回归分析结果证明淋巴结转移和CTTNm RNA表达是影响患者生存时间的主要危险因素。在控制了淋巴结转移等其他因素的情况下,CTTNm RNA表达每增加一个等级患者死亡的危险性增加57%。结论:1.CTTNm RNA在食管鳞癌组织及外周血中均有特异性的高表达,这意味着CTTNm RNA在食管鳞癌的发生、发展中可能起着重要的作用。2.CTTNm RNA是有价值的食管鳞癌微转移标志物,与病人的淋巴结转移、浸润程度、病理分期及预后密切相关,而与性别、年龄、肿瘤部位、大小及肿瘤细胞分化程度没有相关性。3.外周血中CTTNm RNA的表达可能是影响食管鳞癌患者生存状态的独立危险因素。
[Abstract]:Objective: to explore the expression of CTTNm RNA in peripheral blood of patients with esophageal squamous cell carcinoma (ESCC), and to explore the feasibility of its expression as a micrometastasis marker of esophageal squamous cell carcinoma (ESCC) and the influence of its expression on the prognosis of esophageal squamous cell carcinoma (ESCC) patients. Methods: real-time fluorescence quantitative reverse transcriptase polymerase chain reaction was used to detect the expression of CTTNm RNA in 40 patients with esophageal squamous cell carcinoma. The expression of CTTNm RNA in peripheral blood samples of 40 healthy blood donors was detected to determine the range of expression of CTTNRm RNA in normal subjects, and the high expression of CTTNRm RNA in peripheral blood samples of 40 patients with esophageal squamous cell carcinoma (ESCC) before operation was detected. The survival status of 40 patients with esophageal squamous cell carcinoma was observed during 17 months follow-up. Results 1. The expression of CTTNm RNA in esophageal squamous cell carcinoma was significantly higher than that in esophageal stump tissue P0.05. 2.25 patients' peripheral blood samples showed high expression of CTTNm RNA, and the positive rate was 62.5 and 3.The expression of CTTNm in esophageal squamous cell carcinoma was significantly higher than that in esophageal stump tissue. The positive expression of CTTNm RNA in peripheral blood of patients with esophageal squamous cell carcinoma was significantly higher than that in corresponding cancer tissues. The expression of CTTNm RNA in peripheral blood of esophageal cancer patients was consistent with that of corresponding cancer tissues. The expression of CTTNm RNA in peripheral blood of patients with esophageal squamous cell carcinoma was closely related to lymph node metastasis, degree of invasion, pathological stage and prognosis (P 0.05), and was associated with sex, age, history of tobacco and alcohol, tumor size, and so on. All patients with esophageal squamous cell carcinoma were followed up until April 2015. 4 cases were lost, 17 cases died, 19 cases survived. The median survival time of 17 patients with death was 4.5 months and the median follow-up time of 40 patients was 13 months. The 1-year survival rate was 62.5. 15 patients died of CTTNm RNA positive in peripheral blood. The results of univariate COX regression analysis showed that the location of the tumor was 2.783%, the size of the tumor was 2.727%, the degree of differentiation of cancer cells was 3.649%, the depth of invasion was 3.270%, the lymph node metastasis was 24.090%, the distant metastasis was 8.371C, the pathological stage was RR4.135% CTTNM RNA-RNA 5.660) as the prognostic risk factors, age and sex. Smoking and drinking were not statistically significant. Multivariate COX regression analysis showed that lymph node metastasis and CTTNm RNA expression were the main risk factors for survival time. After controlling for other factors such as lymph node metastasis, the risk of death for each additional grade of CTTNm RNA was increased by 57%. Conclusion: 1. CTTNM RNA is highly expressed in esophageal squamous cell carcinoma tissues and peripheral blood, which means that CTTNm RNA may play an important role in the occurrence and development of esophageal squamous cell carcinoma. 2. CTTNm RNA is a valuable micrometastasis marker of esophageal squamous cell carcinoma. It was closely related to lymph node metastasis, degree of invasion, pathological stage and prognosis, but had no correlation with sex, age, tumor location, size and differentiation degree of tumor cells. The expression of CTTNm RNA in peripheral blood may be an independent risk factor for the survival status of esophageal squamous cell carcinoma patients.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.1

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