【作者】 杨双武；

【导师】 张剑宁； 曹卫东；

【作者基本信息】 第四军医大学 ， 外科学， 2011， 硕士

【摘要】 恶性脑肿瘤的诊治在中枢神经系统疾病中仍是一个难点,临床治疗效果不佳。目前医务工作者在不断改良原有治疗方法的同时,正积极探索新的治疗手段。生物靶向治疗作为一种新的治疗手段有望成为恶性肿瘤治疗的有效方法,开展靶向治疗研究的前提就是要有行之有效的生物靶点。人类表皮生长因子受体2型(human epithelial receptor type 2,Her-2)是一种癌基因受体,在多种恶性肿瘤中有所表达。鉴别簇44号(cluster of differentiation 44,CD44)是细胞表面粘附分子中的一种,现已作为多种肿瘤研究及临床诊断的标志物。本研究目的:探讨人类表皮因子受体2型(Her-2)及CD44在常见恶性脑肿瘤中的表达情况及与肿瘤预后的关系。方法:采用免疫组织化学SP法和间接免疫荧光标记法检测胶质母细胞瘤、胶质肉瘤、髓母细胞瘤、间变性少突胶质细胞瘤共120例及10例正常脑组织标本中Her-2、CD44的表达,对数据进行统计学分析。结果: Her-2表达的阳性率在胶质母细胞瘤、胶质肉瘤、髓母细胞瘤和间变性少突胶质细胞瘤中分别是80.0%,73.3%,66.7%和33.3%。CD44表达的阳性率在上述四种肿瘤中分别为86.7%,80.0%,90.0%,73.3%。Her-2在正常脑组织中无表达,CD44在正常脑组织中表达阳性率为20.0%。Her-2与CD44在恶性脑肿瘤中的表达无相关性(P>0.05),但两者均与肿瘤预后关系密切。免疫荧光标记显示两者存在共定位现象。结论: Her-2在胶质母细胞瘤、胶质肉瘤、髓母细胞瘤中高表达,而在间变性少突胶质细胞瘤中相对低表达,CD44则普遍高表达。未发现两者在恶性脑肿瘤中表达具有相关性,但二者均与肿瘤的预后有密切关系,具有协同作用。因此Her-2与CD44有望成为脑肿瘤联合免疫治疗的联合靶位,在脑肿瘤诊治中发挥重要作用。更多还原

【Abstract】 The diagnosis and treatment of malignant brain tumors in the central nervous system diseases are difficulty all the way, the effect of clinical treatment is not very well. At present the medical workers refine original treatments constantly and explore new treatments actively. Biological targeted therapy as a new treatment method is expected to become effective method to malignant tumors. the premise to carry out the targeting therapy research is having effective biological targets. Human epidermal growth factor receptor type 2 (Her-2) is a cancer gene receptor, in a variety of malignant tumor, to express. CD44 is a sort of cell surface adhesion molecules. Now it are, in variety of tumor, the research and clinical diagnostic markers.Objective To detect and analyze human epidermal growth factor receptor(HER-2) and CD44 in different malignant brain tumors, and to evaluate their prognostic significance.Methods Using immunohistochemistry and indirect immunofluorescence to detect the expression of Her-2 and CD44 in malignant brain tumors and analyzing the experimental data. The specimens contain 10 normal brain tumors and 120 malignant brain tumors that are glioblastoma, gliosarcoma, medulloblastoma and anaplastic oligodendroglioma.Results The positive rate of Her-2 in the glioblastoma, gliosarcoma, medulloblastoma, and anaplastic oligodendroglioma respectively were 80.0%, 73.3%, 66.7% and 33.3%. The positive rate of CD44 in these four tumors respectively were 86.7%, 80.0%, 90.0%, 73.3%. The expression of Her-2 in normal brain tissue was none, but CD44 was 20.0% . The expression in malignant brain tumor had no correlation between Her-2 and CD44 (P>0.05), but they both correlate with tumor prognosis. Conclusions The expressions of Her-2 were not same in malignant brain tumors, the expressions of CD44 were generally high. No correlation between Her-2 and CD44, but they have synergistic effect with the prognosis of tumors. Her-2 and CD44 are expected to be combined target site for target therapies of brain tumor. They will play an important role in the brain tumor diagnosis and treatment.更多还原