上消化道双源癌Her-2、HPV表达与临床病理及临床特征分析研究

发布时间：2018-06-10 06:52

本文选题：双源癌 + 食管鳞癌　；参考：《山西医科大学》2015年硕士论文

【摘要】：目的:通过检测上消化道双源癌中Her-2蛋白表达和HPV感染情况,探讨了同一系统中不同组织类型的恶性肿瘤在发生发展过程中的联系及其与临床病理的关系;通过对山西省肿瘤医院34例上消化道双源癌患者的临床病理资料进行回顾性分析,研究山西地区上消化道双源癌的发病规律、诊治策略和预后因子。方法:(1)采用免疫组织化学法(immunohistochemistry IHC)检测39例食管、胃双源癌标本中Her-2蛋白的表达。采用原位杂交技术(in situ hybridization ISH)对39例食管、胃双源癌标本中HPV-DNA进行检测。(2)收集上消化道双源癌病例及数据处理,分析山西地区上消化道双源癌的相关临床特征。结果:(1)Her-2蛋白过表达与上消化道双源癌中食管鳞癌的分化程度、浸润深度、淋巴结转移及患者的年龄性别均无关,差异无统计学意义〔P0.05〕;Her-2蛋白过表达与上消化道双源癌中胃腺癌的浸润深度、淋巴结转移因素相关,差异有统计学意义〔P0.05〕,与患者的年龄、性别及肿瘤的分化程度无关,差异无统计学意义〔P0.05〕。(2)HPV感染与上消化道双源癌中食管鳞癌和胃腺癌的分化程度、浸润深度、淋巴结转移及患者的年龄性别均无关,差异无统计学意义〔P0.05〕。(3)Her-2蛋白过表达在上消化道双源癌肿瘤组织中呈现一致性,Kappa=0.75,P0.05。HPV-DNA在上消化道双源癌肿瘤组织中也呈现一致性,Kappa=0.80,P0.05.(4)结合上消化道双源癌患者临床资料分析,其预后与患者年龄、治疗方式、以及地区分布有关。结论:(1)Her-2和HPV可能是上消化道双源癌中食管鳞癌和胃腺癌的共同相关致病危险因素。(2).研究发现山西地区的上消化道双源癌有明显的地域集中分布性,早期诊断后施行同期手术,并结合放化疗等综合治疗可明显提高疗效和改善预后。
[Abstract]:Objective: to investigate the relationship between the expression of Her-2 protein and HPV infection and the clinicopathology of malignant tumors of different types in the same system by detecting the expression of Her-2 protein and the infection of HPV in the double carcinomas of upper digestive tract. By retrospective analysis of the clinicopathological data of 34 patients with upper gastrointestinal cancer in Shanxi Cancer Hospital, the pathogenesis, diagnosis and treatment strategies and prognostic factors of double source carcinoma of upper digestive tract in Shanxi were studied. Methods the expression of Her-2 protein in 39 cases of esophageal and gastric carcinomas was detected by immunohistochemical method. In situ hybridization (ish) technique was used to detect HPV-DNA in 39 cases of esophageal and gastric carcinomas. Results the overexpression of Her-2 protein was not related to the degree of differentiation, depth of invasion, lymph node metastasis and age and sex of esophageal squamous cell carcinoma. There was no significant difference between the expression of P0.05 and Her-2 protein and the depth of gastric adenocarcinoma invasion and lymph node metastasis, but there was no significant difference between the expression of P0.05and the age, sex and differentiation of the tumor. There was no significant difference between HPV infection and the differentiation, depth of invasion, lymph node metastasis, age and sex of esophageal squamous cell carcinoma and gastric gland carcinoma. There was no significant difference in the overexpression of P0.05, P0. 05 and Her-2 protein in the tumor tissues of double origin carcinoma of upper digestive tract. The clinical data of patients with double carcinomas of upper digestive tract were analyzed in combination with Kappa-0.75 and P0.05. 05. HPV-DNA in the tumor tissues of double carcinomas of upper digestive tract, and the clinical data of patients with double carcinomas of upper digestive tract were also analyzed, and the clinical data of patients with double carcinomas of upper digestive tract were analyzed. The prognosis is related to patient age, treatment style, and regional distribution. Conclusion Her-2 and HPV may be the common risk factors of esophageal squamous cell carcinoma and gastric adenocarcinoma in upper digestive tract carcinomas. The study found that the upper digestive tract double source carcinoma in Shanxi area has the obvious regional concentration distribution, the early diagnosis carries on the simultaneous operation after the early diagnosis, combined with the radiotherapy and chemotherapy and so on comprehensive treatment can obviously enhance the curative effect and the improvement prognosis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735

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