【作者】 孙建；

【导师】 张莉；

【作者基本信息】 新疆医科大学 ， 肿瘤学， 2011， 硕士

【摘要】 目的：探讨新疆汉族、哈萨克族和维吾尔族食管鳞癌患者血清及组织中VEGF、EGFR、ES、HER2、NF-kBp表达水平的差异及临床意义。方法：采用酶联免疫法(ELISA)和免疫组化方法同时检测汉族(20例)、哈萨克族(20例)和维吾尔族(20例)食管鳞癌患者血清及组织中VEGF、EGFR、ES、HER2、NF-kBp的表达,分析其与临床病理及疗效的关系。结果：1.汉族食管癌患者的血清VEGF、ES水平高于维族和哈族患者(P<0.05)；肿瘤组织中临床分期Ⅱ、Ⅲ、Ⅳ期的VEGF蛋白表达阳性率分别为14.29%、50.00%、50.00%,分期越晚VEGF蛋白表达阳性率越高(P<0.05)；有淋巴转移者VEGF蛋白表达阳性率(78.13%)高于无淋巴转移者(25.00%)(P<0.05)；治疗前食管癌患者清VEGF表达高于正常组(P<0.05)；组织中VEGF阴性组有效率(74.28%)高于阳性组完全缓解率(44.00%)(P<0.05)；2.不同性别组织中EGFRR蛋白表达比较有统计学意义(P<0.05),治疗前食管癌患者血清EGFR表达高于正常组(P<0.05)；3.治疗前后食管癌患者血清ES表达高于正常组(P<0.05)；不同疗效组织中Es蛋白表达无统计学差异；4.组织中HER-2蛋白表达在病理分化Ⅰ、Ⅱ、Ⅲ期的阳性率分别为70.00%、30.00%、20.00%,分化程度越高HER-2蛋白表达阳性率越低(P<0.05)；5.组织中有淋巴转移者NF-kBp蛋白表达阳性率(65.63%)高于无淋巴转移者(39.27%)(P<0.05); NF-kBp65阴性组的中位生存期(26个月)高于阳性组(20个月)(P<0.05)；余肿瘤标记物的表达与生存期无关(P>0.05)；结论：1.部分血清肿瘤标记物水平(VEGF、ES)在新疆汉族、哈族、维族食管鳞癌具有民族差异;2.同时联合检测食管鳞癌血清和组织中的肿瘤标记物,对判断食管癌的疗效具有一定的指导意义。3.检测食管癌患者血清及组织中的同一个分子标记物其表达具有不一致性。更多还原

【Abstract】 Objective:To study the expression difference and the clinicopathological significa nce of serum and tissue of VEGF、EGFR、ES、HER-2、NF-kBp in Han、Uygur and Kazakh patients with esophageal squamous cell carcinoma in Xinjiang. Method s:To Adopt enzyme-linked immunosorbent method (ELISA) and immunohistochemic-al method to detect serum and tissue of VEGF、EGFR、ES、HER-2、NF-kBp e-xpression and study these biomarkers with clinical pathology and curative effect in 60 cases patients with esophageal squamous cell carcinoma. Results:1.The serum VEGF、ES levels in Han patients were obviously higher than Uygur and Kazakh patients(P<0.05); the clinical stagesⅡ,Ⅲ,ⅣVEGF protein expression rate in tis-sue, respectively of 14.29%,50.00%,50.00%; the later of staging the higher of the expression rate in VEGF protein (P<0.05); VEGF protein expression rate in ly mph node metastases was higher than without lymph node metastases, respectively of 78.13%、25.00%(P<0.05); Before treatment, the serum VEGF expression were h igher than normal group in esophageal carcinoma (P<0.05); Tissue of VEGF negati-ve group complete remission than positive groups complete response rate, respecti-vely of 74.28%、44.%(P<0.05); 2.EGFR protein expression with a statistical signif icance in different gender (P<0.05); Before the treatment, the serum EGFR express-ion were higher than normal group in esophageal carcinoma (P<0.05); 3.Esophagea-1 patients serum ES expression were higher than normal group in before and after treatment(P<0.05), ES protein expression was not statistically significant in different therapeutic(P<0.05); 4.the different pathologic degreeⅠ、Ⅱ、Ⅲperiod of HER-2 protein expression rate, respectively 70%、30%、20%, the early of pathologic degr-ee the higher of the expression rate in HER-2 protein (P<0.05); 5. NF-kB protein expression rate in lymph node metastases was higher than without lymph node met-astases, respectively 65.63％、39.27%(P<0.05); But there was not statistically si-gnificant in other clinical factors and curative effect(P>0.05); NF-kB negative grou-ps median surivial time higher than positive group(P<0.05); there was not statistical-ly significant about median srvival time in other tumor marker of positive and ne gative groups(P>0.05); Conclusion:Parts of serum markers (VEGF、ES) expression were different in Uygur、Han and Kazakh patients in Xinjiang; Combining serum and tissue of tumor marker, To judge the curative effect of esophageal cancerhas c ertain directive significance.更多还原