【作者】 田文芳；

【导师】 李新国；

【作者基本信息】 中南大学 ， 妇科肿瘤学， 2008， 硕士

【摘要】 目的:探讨卵巢上皮性肿瘤组织中尿激酶型纤溶酶原激活物受体蛋白（Urokinase-type Plasminogen Activator Receptor,uPAR）和乳腺癌易感基因1（breast cancer susceptibility gene 1,BRCA-1）的表达,探讨其相关性及临床意义。方法:42例经病理证实的卵巢上皮性癌标本（浆液性囊腺癌30例,粘液性囊腺癌10例,子宫内膜样腺癌2例）,15例交界性卵巢肿瘤,12卵巢上皮性良性肿瘤,采用免疫组化法检测uPAR,BRCA-1的表达,应用SPSS15.0软件应用Kruskal-Wallis H检验法（成组设计多个样本比较秩和检验）、Mann-Whitney U检验法（两样本比较秩和检验）及直线相关分析。结果:1.卵巢上皮性癌组织中BRCA1的阳性表达率为33.3%（14/42）,卵巢交界性肿瘤组织中为60%（9/15）,上皮性良性肿瘤组织中为83.3%（10/12）。卵巢上皮性癌组织中BRCA—1蛋白表达阳性率显著低于良性卵巢上皮肿瘤和交界性卵巢肿瘤（P＜0.005）。卵巢癌G₁级BRCA-1阳性率90%（9/10）,G₂级阳性率22.2%（4/18）,G₃级中阳性率14.3%（2/14）,G1与G3、G2与G3之间的阳性表达率存在统计学差异（p＜0.05）,说明随着分化程度的降低,BRCA-1的阳性表达率逐渐下降。伴淋巴结转移的患者中BRCA-1阳性率25%（3/12）,无淋巴结转移的患者阳性率50%（8/16）,结果表明,BRCA-1的表达下调与卵巢癌的淋巴结转移率显著相关（P＜0.05）。2.卵巢上皮性良性肿瘤中uPAR阳性表达率为25%（3/12）;在交界性卵巢肿瘤中,阳性表达率为53.3%8/15);在卵巢上皮性癌中阳性表达率为83.3%（35/42）。卵巢癌中uPAR表达明显高于良性及交界性肿瘤（P＜0.005）。卵巢癌Ⅰ期患者中uPAR阳性率100%（9/9）,Ⅱ期阳性率90.9%（10/11）,Ⅲ期阳性率91.7%（11/12）,Ⅳ期阳性率50%（5/10）。随着临床期别的升高,uPAR的阳性表达率逐渐下降。卵巢癌G₁级uPAR阳性率90%（9/10）,G₂级中阳性率88.9%（16/18）,G₃级中阳性率71.4%（10/14）,表明分化程度降低,uPAR的阳性表达率下调。伴淋巴结转移患者中uPAR阳性率58.3%（7/12）无淋巴结转移的患者中uPAR阳性率81.3%（13/16）,结果表明,uPAR的表达下调与卵巢癌的淋巴结转移显著相关（P＜0.05）。3.卵巢上皮性癌中uPAR和BRCA-1的表达进行Spearman等级相关分析,相关系数为—0.350,P=0.002,具有统计学显著性差异。（P＜0.05）结论:1.早期、高分化卵巢癌组织中uPAR高表达,提示uPAR至少在卵巢癌的早期发生发展过程中发挥重要的作用。2.BRCA-1表达下调促进卵巢上皮性癌的发生发展,与其侵袭转移密切相关。3.uPAR与BRCA-1的表达呈负相关,提示两种蛋白可能通过不同途径参与卵巢上皮性癌的发生发展。更多还原

【Abstract】 Objective: It was to observe the expression and sense of UPAR、BRCA-1 in tissue of Epithelial Ovarian Tumour and its correlation.Methods: BRCA 1 and uPAR protein expressions were detected in 69 epithelial ovarian tumours. Kaplan-Meier method was used to analyze the relationship between their expressions. Spearman’s method was used to analyze its correlations.Results: 1.BRCA1 positive expression rates were 33.3% (14/42)in ovarian cancers, 60 % (9/15)in borderline epithelial ovarian tumour, and 83.3 %(10/12)in benign epithelial ovarian tumour respectivdy. The positive rate of BRCA1 protein in ovarian cancer was lower than that in benign and borderline epithelial ovarian tumours。(P<0.05)。2.The positive rate of uPAR expression in ovarian cancer is 83.3% (35/42),53.3%(8/15) in borderline epithelial ovarian tumour,and 25% (3/12) in benign epithelial ovarian tumour respectivdy.3. The expression of BRCA1 was negative correlated wth uPAR in epithelial ovarian cancer (r=-0.350, P<0.05) The positive rate of uPAR protein in ovarian cancer was higher than that in benign and borderline epithelial ovarian tumours。(P<0.005)。Conclusion: 1. The high expression level and intensity of uPAR at the early stage and good play differential grade ovarian cancer tissue showed that uPAR may, at least,played a important role at the early stage. 2. The low expression of BRCA-1 in ovarian cancer tissue showed that BRCA-1 might play an important roles in the infiltration,metastasis of epithelial ovarian cancer.3. The expression level and intensity of uPAR was negative correlated to BRCA-1 in the epithelial ovarian cancer tissue,showde that they may played important roles in the infiltration,metastasis of epithelial ovarian cancer in different ways.更多还原