Plexin-B1与MMP-9在胰腺癌组织中的表达及意义
发布时间：2018-07-18 12:42
【摘要】：目的:通过检测Plexin-B1和MMP-9在人体胰腺癌组织、正常胰腺组织中的表达情况以及相关性,并随访获取术后生存时间资料,探讨Plexin-B1和MMP-9在胰腺癌发生发展中的作用以及与预后的关系。方法:1.本研究选取2012年1月至2015年1月在湖南省人民医院肝胆外科接受胰腺手术治疗的39例术后病理确诊为胰腺导管腺癌的患者作为实验组,获取其胰腺癌组织蜡块。对39例胰腺癌根据2010年美国肿瘤联合会(AJCC)第七版TNM分期系统进行分期。通过查阅病历获取患者基本临床及病理资料。取10例因胰腺外伤及其他原因接受胰腺切除者的正常胰腺组织蜡块,作为对照组。运用免疫组织化学的方法检测Plexin-B1和MMP-9在胰腺癌组织以及正常胰腺组织中的表达,HE染色观察胰腺癌组织中的神经侵犯现象,统计分析表达情况与临床病理资料间的关系以及表达的相关性。2.从接受手术治疗当天开始计算生存时间,术后通过电话、电子邮件、手机短信、门诊或住院复查等方式获取生存时间资料,以月为单位,以患者死亡或者2015年12月为终点。对Plexin-B1以及MMP-9的表达以及各临床病理因素与手术后生存时间的关系进行单因素分析,经单因素分析所得的P0.1的可能对生存时间产生影响的因素纳入多因素生存分析。结果:1.Plexin-B1和MMP-9在胰腺癌组织中主要表达于胰腺癌细胞的胞浆和胞膜,二者在胰腺癌组织中都呈高表达趋势(97.4%和92.3%),明显高于正常胰腺组织(10%和10%),差异有统计学意义。MMP-9的表达在有神经侵犯、肿瘤分化程度低的胰腺癌组织中表达更高,差异有统计学意义。Plexin-B1与MMP-9的表达呈正相关关系(相关系数r=0.403 P=0.011)。2.34名患者获得术后随访,排除术后短期因并发症死亡的2例,对其余32例胰腺癌患者临床病理因素对生存期的影响进行单因素分析,结果提示MMP-9阳性表达、神经侵犯、分化程度低、TNM分期较晚与患者术后生存时间缩短显著相关(P0.05)。将P0.1的可能对生存时间产生影响的因素纳入多因素生存分析Cox风险模型,结果提示神经侵犯、肿瘤分化程度对患者术后生存时间的影响在纳入分析的各相关因素中相对独立,相对危险度分别为0.215(P=0.002)和3.207(P=0.02)。结论:1.Plexin-B1与MMP-9在胰腺癌组织中高表达,高于正常胰腺组织,二者的表达呈正相关关系,说明二者共同参与了胰腺癌的发生及发展过程。2.MMP-9在发生神经侵犯的胰腺癌组织中表达较高,提示MMP-9可能参与胰腺癌的神经侵犯过程。3.MMP-9阳性表达、发生神经侵犯、肿瘤低分化、TNM分期较晚与胰腺癌患者手术后生存时间缩短显著相关,其中,发生神经侵犯、肿瘤低分化对胰腺癌患者手术后生存时间缩短的影响相对独立。
[Abstract]:Objective: to investigate the expression and correlation of Plexin-B1 and MMP-9 in human pancreatic carcinoma and normal pancreatic tissues, and to investigate the role of Plexin-B1 and MMP-9 in the development and prognosis of pancreatic cancer. Method 1: 1. From January 2012 to January 2015, 39 patients with pancreatic ductal adenocarcinoma were treated by pancreatic surgery in the Department of Hepatobiliary surgery, Hunan Provincial people's Hospital. Thirty-nine cases of pancreatic cancer were staging according to the seventh TNM staging system of the American Federation of Neoplasms (AJCC) in 2010. The basic clinical and pathological data of the patients were obtained by consulting the medical records. The normal pancreatic tissue wax of 10 patients with pancreatic trauma and other reasons were taken as control group. The expression of Plexin-B1 and MMP-9 in pancreatic carcinoma and normal pancreatic tissues were detected by immunohistochemical method. Statistical analysis of the relationship between expression and clinicopathological data and the expression of correlation. 2. The survival time was calculated from the day of operation, and the survival time was obtained by telephone, email, SMS, outpatient or inpatient reexamination after the operation. The survival time was measured in months, with the death of the patient or December 2015 as the end point. The expression of Plexin-B1 and MMP-9 and the relationship between the clinicopathological factors and the survival time after operation were analyzed by univariate analysis. The factors that may influence the survival time of P0.1 were included in the multivariate survival analysis. Results 1. Plexin-B1 and MMP-9 were mainly expressed in the cytoplasm and membrane of pancreatic cancer cells. The expression of MMP-9 in pancreatic carcinoma was significantly higher than that in normal pancreatic tissue (97.4% and 92.3%), and the expression of MMP-9 was significantly higher in pancreatic carcinoma with neural invasion and low tumor differentiation than in normal pancreatic tissue (10% and 10%), and the expression of MMP-9 in pancreatic carcinoma was significantly higher than that in normal pancreatic tissue (10% and 10%). There was a positive correlation between the expression of MMP-9 and Plexin-B1 (r = 0.403 P0.011) .2.34 patients were followed up after operation, and 2 cases died because of complications after operation. Univariate analysis was carried out on the clinicopathological factors of the other 32 patients with pancreatic cancer. The results showed that the positive expression of MMP-9, the invasion of nerves and the late TNM stage were significantly correlated with the shortened survival time (P0.05). The factors that may affect survival time of P0.1 were included in Cox risk model of multivariate survival analysis. The results indicated that the influence of neural invasion and tumor differentiation on postoperative survival time of patients was relatively independent among the factors involved in the analysis. The relative risk was 0.215 (P0. 002) and 3.207 (P0. 02), respectively. Conclusion: 1. The expression of Plexin-B1 and MMP-9 in pancreatic carcinoma is higher than that in normal pancreatic tissue. The positive correlation between the expression of MMP 9 and Plexin-B1 suggests that both of them are involved in the occurrence and development of pancreatic carcinoma. 2. The expression of MMP-9 is higher in pancreatic carcinoma with neural invasion. The results suggest that MMP-9 may be involved in the neuroinvasive process of pancreatic cancer. 3. The positive expression of MMP-9 may be involved in the process of pancreatic cancer. The late TNM stage of low differentiation of tumor may be associated with the shortened survival time of pancreatic cancer patients after operation, among which, nerve invasion may occur. The effect of low tumor differentiation on postoperative survival time of pancreatic cancer patients is relatively independent.
【学位授予单位】：湖南师范大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.9
[Abstract]:Objective: to investigate the expression and correlation of Plexin-B1 and MMP-9 in human pancreatic carcinoma and normal pancreatic tissues, and to investigate the role of Plexin-B1 and MMP-9 in the development and prognosis of pancreatic cancer. Method 1: 1. From January 2012 to January 2015, 39 patients with pancreatic ductal adenocarcinoma were treated by pancreatic surgery in the Department of Hepatobiliary surgery, Hunan Provincial people's Hospital. Thirty-nine cases of pancreatic cancer were staging according to the seventh TNM staging system of the American Federation of Neoplasms (AJCC) in 2010. The basic clinical and pathological data of the patients were obtained by consulting the medical records. The normal pancreatic tissue wax of 10 patients with pancreatic trauma and other reasons were taken as control group. The expression of Plexin-B1 and MMP-9 in pancreatic carcinoma and normal pancreatic tissues were detected by immunohistochemical method. Statistical analysis of the relationship between expression and clinicopathological data and the expression of correlation. 2. The survival time was calculated from the day of operation, and the survival time was obtained by telephone, email, SMS, outpatient or inpatient reexamination after the operation. The survival time was measured in months, with the death of the patient or December 2015 as the end point. The expression of Plexin-B1 and MMP-9 and the relationship between the clinicopathological factors and the survival time after operation were analyzed by univariate analysis. The factors that may influence the survival time of P0.1 were included in the multivariate survival analysis. Results 1. Plexin-B1 and MMP-9 were mainly expressed in the cytoplasm and membrane of pancreatic cancer cells. The expression of MMP-9 in pancreatic carcinoma was significantly higher than that in normal pancreatic tissue (97.4% and 92.3%), and the expression of MMP-9 was significantly higher in pancreatic carcinoma with neural invasion and low tumor differentiation than in normal pancreatic tissue (10% and 10%), and the expression of MMP-9 in pancreatic carcinoma was significantly higher than that in normal pancreatic tissue (10% and 10%). There was a positive correlation between the expression of MMP-9 and Plexin-B1 (r = 0.403 P0.011) .2.34 patients were followed up after operation, and 2 cases died because of complications after operation. Univariate analysis was carried out on the clinicopathological factors of the other 32 patients with pancreatic cancer. The results showed that the positive expression of MMP-9, the invasion of nerves and the late TNM stage were significantly correlated with the shortened survival time (P0.05). The factors that may affect survival time of P0.1 were included in Cox risk model of multivariate survival analysis. The results indicated that the influence of neural invasion and tumor differentiation on postoperative survival time of patients was relatively independent among the factors involved in the analysis. The relative risk was 0.215 (P0. 002) and 3.207 (P0. 02), respectively. Conclusion: 1. The expression of Plexin-B1 and MMP-9 in pancreatic carcinoma is higher than that in normal pancreatic tissue. The positive correlation between the expression of MMP 9 and Plexin-B1 suggests that both of them are involved in the occurrence and development of pancreatic carcinoma. 2. The expression of MMP-9 is higher in pancreatic carcinoma with neural invasion. The results suggest that MMP-9 may be involved in the neuroinvasive process of pancreatic cancer. 3. The positive expression of MMP-9 may be involved in the process of pancreatic cancer. The late TNM stage of low differentiation of tumor may be associated with the shortened survival time of pancreatic cancer patients after operation, among which, nerve invasion may occur. The effect of low tumor differentiation on postoperative survival time of pancreatic cancer patients is relatively independent.
【学位授予单位】：湖南师范大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.9
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