【作者】 许韩峰；

【导师】 吴斌；

【作者基本信息】 中国医科大学 ， 外科学， 2006， 硕士

【摘要】 目的 泌尿系肿瘤中肾肿瘤比较常见,且多数为恶性。在原发肾恶性肿瘤中,肾癌占80%以上,肾盂癌占8%左右。肾癌患者的临床表现多样,当其向周围浸润至肾盂、肾盏时,同肾盂癌之间难以鉴别。因两者的手术及治疗方案不同,在术前能明确的鉴别诊断有利于临床治疗。 目前有关泌尿系肿瘤的标志物检测主要集中在对尿液中肿瘤标志物的研究。肾盂癌是上尿路移行细胞癌,其尿液中所表达的肿瘤标志物水平很高。基质金属蛋白酶9(MMP-9)是Ⅳ胶原酶,主要作用为降解基底膜的主要成分—Ⅳ型胶原。而基底膜为上皮性肿瘤侵袭和转移的第一障碍。研究表明在BTCC患者的膀胱灌注液中MMP-9有71%以酶原表达,且表达强度同肿瘤的分级、分期相关。同时MMP-9在肾癌组织中也有异常表达。有关肾癌、肾盂癌的血液和尿液中基质金属蛋白酶9的表达水平,尚无相关报道。 实验材料的方法 1.实验材料: 收集中国医科大学附属一院和附属二院2003年12月至2005年1月共41例血液和尿液样本。其中肾癌17例,肾盂癌14例,正常人10例。 2.实验方法: 样本经过标准化处理后,于深冻冰箱保存,于统一时间进行测定。采用酶联免疫法(ELISA)测定患者尿液和血液样本中MMP-9的浓度。用SPSS11.0分析血液、尿液的基质金属蛋白酶9浓度及其比值。更多还原

【Abstract】 ObjectRenal tumor is a common disease in urological tumor, whereas most of them are malignant. In primary renal carcinoma, renal cell cancer (RCC) occupies 80% , renal transitional cell carcinoma (TCC) 8%. Renal cell cancer patients’ clinical symptoms are very diversity, especially after the invasion into pelvis, it is very difficult to perform different diagnosis with TCC. For the different operation way between RCC and TCC, this differential diagnosis is very important to clinical treatment.Nowadays there are many articles about tumor markers in body fluid, the research about urology cancer is mainly in urine markers. As renal pelvic carcinoma is a transitional cancer, the level of tumor marker in the urine is quitely high. Matrix metalloproteinase 9 ( MMP - 9) is known as Ⅳ gelatinase mainly to degradate basement membrane type Ⅳ collagen. Basement membrane is first barrier against the invasion and diversion of epithelial tumor. A recent study demonstrates there is about 71 percent MMP - 9 enzyme precursor analysis in the perfusion fluid of bladder in BTCC patients. Meanwhile, there is abnormal expression of MMP -9 in RCC tissues. However, the MMP -9 level of RCC and TCC in urine and blood samples are still not researched.Materials and Methods1. Sample collections:this study include 41 patients, all take both urine and blood samples, inwhich there 17 cases of renal cell carcinoma, 14 cases of renal transitional carcinoma and 10 cases of normal persons.2. Methods;After dealing samples with standard way, the samples are kept within deep freezer. And do the experiment all together. We use ELISA to test MMP - 9 in urine and blood samples. SPSS 11.0 for windows is used to analysis the data.Results1. MMP-9 in blood samples;In 41 cases of blood samples, the data in different groups are not different in statistics.2. MMP - 9 in urine samples;MMP - 9 value in the TCC group and RCC group is obviously higher than control group. (P <0. 01) It is different between TCC group and RCC group. (P < 0. 01)3. Blood MMP - 9/urine MMP - 9 value;There is not different among TCC group RCC group and the control group (P >0. 05).4. Amalgamate TCC group and RCC group to the cancer group, the urine MMP - 9 value and blood MMP - 9/urine MMP - 9 is obviously different with control group, but no difference is shown in the blood MMP —9 value.Conclusions1. There are no different between renal TCC and RCC and normal persons in MMP -9 in blood samples.2. MMP - 9 in urine samples of renal transitional cancer is obviously higher than in the urine of RCC patients and normal persons. MMP -9 is a good urine tumor marker for TCC, and can be used to make diagnosis of TCC and its differential diagnosis with RCC.更多还原