【作者】 李武杰；

【导师】 孙彦；

【作者基本信息】 青岛大学 ， 耳鼻咽喉头颈外科学， 2008， 硕士

【摘要】 目的:本课题通过免疫组化SP法,检测胰岛素生长因子1受体(IGF-1R)和尿激酶型纤溶酶原活化因子(u-PA)在喉咽癌组织及癌旁喉咽黏膜组织中的表达,并将IGF-1R与u-PA在喉咽癌组织中的表达进行相关性分析,探讨IGF-1R与u-PA在喉咽癌发生、发展、浸润和转移中的作用以及它们在喉咽癌浸润转移中的相互关系,为喉咽癌的诊断、治疗和预后判断提供参考依据。材料与方法:采用免疫组织化学SP法,分别检测55例喉咽癌组织、42例癌旁喉咽黏膜组织及40例会厌囊肿粘膜组织中IGF-1R蛋白和u-PA蛋白的表达情况。采用SPSS11.0统计学软件对实验数据进行统计学处理,率的比较采用x2检验,检验标准以α=0.05为显著性检验水准。结果:①IGF-1R在喉咽癌组织、癌旁喉咽粘膜组织及会厌囊肿粘膜组织中的阳性表达率分别为81.82%,52.38%和17.50%,3组间两两比较,差异均有统计学意义(P＜0.01);在阳性表达组织中,3组的强阳性率分别为72.72%,30.95%和2.50%,3组间两两比较,差异亦均有统计学意义(P＜0.01)。②u-PA在喉咽癌组织、癌旁喉咽粘膜组织及会厌囊肿粘膜组织中的阳性表达率分别为85.45%,42.86%和20.00%,3组间两两比较,差异均有统计学意义(P＜0.05);在阳性表达组织中,3组的强阳性率分别为76.36%,23.81%和2.50%,3组间两两比较,差异亦均有统计学意义(P＜0.01)。③IGF-1R在喉咽癌有淋巴结转移组和无淋巴结转移组中的强阳性表达率分别为82.61%和22.22%,二者之间差异有统计学意义(P＜0.01)。④u-PA蛋白在喉咽癌有淋巴结转移组和无淋巴结转移组中的强阳性表达率分别为78.26%和44.44%,二者之间差异有统计学意义(P＜0.01)。⑤IGF-1R在3年内存活组和死亡组中的阳性表达率分别为76.92%和88.89%,二者之间差异没有统计学意义(P＞0.05)。⑥u-PA在3年内存活组和死亡组中的阳性表达率分别为84.62%和88.89%,二者之间差异没有统计学意义(P＞0.05)。⑦IGF-1R在5年内存活组和死亡组中的阳性表达率分别为75.00%和86.67%,二者之间差异没有统计学意义(P＞0.05)。⑧u-PA在5年内存活组和死亡组中的阳性表达率分别为75.00%和80.00%,二者之间差异没有统计学意义(P＞0.05)。⑨45例IGF-1R蛋白阳性表达的喉咽癌组织中42例u-PA蛋白呈阳性表达;10例IGF-1R蛋白阴性表达的喉咽癌组织中5例u-PA蛋白亦呈阴性表达,二者在喉咽癌组织中的表达有明显的相关性(P＜0.01)。结论:1.IGF-1R蛋白和u-PA蛋白的阳性表达率在喉咽癌组织中显著增高,在癌旁组中的表达高于在对照组中的表达,提示IGF-1R和u-PA在喉咽癌组织中高表达与喉咽癌的发生发展有关。2.IGF-1R蛋白和u-PA蛋白的强阳性表达与喉咽癌有无淋巴结转移明显相关,检测喉咽癌组织中IGF-1R和u-PA的表达,可能有助于估计喉咽癌淋巴结转移。3.喉咽癌组织中IGF-1R表达与u-PA表达呈正相关,推测两者可能在喉咽癌发生、发展以及淋巴结转移中起了协同作用。更多还原

【Abstract】 Objective:This research subject investigates, through immunohistichemistry SP method, the expressions of IGF-1R protein and u-PA protein in the tissue of laryngopharynx carcinoma and in the tissue adjacent to cancer, so as to discusses its mechanism of pathogenesis, development, invasion and metastasis, to find an useful indicator for early diagnosis of laryngopharynx carcinoma and pxovide the new methods and ideas for therapy and predict the prognosis of laryngopharynx carcinoma.Materials and methods:By adopting immunohistichemistry SP method, the expressions of IGF-1R protein and u-PA protein in the tissue of 55 laryngopharynx carcinoma cases, 42 adjacent to cancer cases and 40 epiglottis cyst cases were detected. All the datas were analyzed by SPSS 11.0 statistical software. The comparison of positive rates uses the Chi-square and Fisher, Statistically significant level was considered as "alpha equals 0.05".Results:①The rates of positive expression of IGF-1R protein in the tissue of laryngopharynx carcinoma, in the tissue adjacent to cancer and in the tissue of epiglottis cyst are 81.82%, 52.38% and 17.50% respectively, the difference between any two group is significant (P<0.01); The rates of powerful positive expression of IGF-1R protein in the positive expression are 72.72%, 30.95% and 2.50% respectively, the difference between any two is significant(P<0.01).②The rates of positive expression of u-PA protein in the tissue of laryngopharynx carcinoma, in the tissue adjacent to cancer and in the tissue of epiglottis cyst are 85.45%, 42.86% and 20.00% respectively,the difference between any two group is significant (P<0.01); The rates of powerful positive expression of u-PA protein in the tissue of laryngopharynx carcinoma, in the tissue adjacent to cancer and in the tissue of epiglottis cyst are 76.36%, 23.81% and 2.50% respectively, the difference between any two group is significant(P<0.01).③The rates of powerful positive expressions of IGF-1R protein in the tissue of metastasis and non-metastasis are 82.61% and 22.22% respectively. The difference in the two groups has statistical significance(P<0.01).④The rates of powerful positive expressions of u-PA protein in the tissue of metastasis and non-metastasis are 78.26% and 44.44% respectively. The difference in the two groups has statistical significance(P<0.01). ⑤The rates of positive expressions of IGF-1R protein in the groups of the 3-year survival and 3-year death are 76.92% and 88.89% respectively. The difference in the two groups has no statistical significance(P>0.05).⑥The rates of positive expressions of u-PA protein in the groups of the 3-year survival and 3-year death are 84.62% and 88.89% respectively. The difference in the two groups has no statistical significance(P>0.05).⑦The rates of positive expressions of IGF-1R protein in the groups of the 5-year survival and 5-year death are 75.00% and 86.67% respectively. The difference in the two groups has no statistical significance(P>0.05).⑧The rates of positive expressions of u-PA protein in the groups of the 5-year survival and 5-year death are 75.00% and 80.00% respectively. The difference in the two groups has no statistical significance(P>0.05).⑨There are 42 positive expressions of u-PA protein cases in the 45 positive expressions of IGF-1R protein cases. There are 5 negative expressions of u-PA protein cases in the 10 negative expressions of IGF-1R protein cases. The IGF-1R expression was closely correlated with the u-PA expression(P<0.01).Conclusions: 1. The rates of positive expressions of IGF-1R protein and u-PA protein are obviously increase in the tissue of laryngopharynx carcinoma, and in the tissue adjacent to cancer are higher than in the tissue of epiglottis cyst, . It is pointed out that IGF-1R and u-PA take part in the pathogenesis and development of laryngopharynx carcinoma.2.The powerful positive expressions of IGF-1R protein and u-PA protein obviously concern the lymph node metastasis. It indicated that the detection of IGF-1R and u-PA in the tissue of laryngopharynx carcinoma might be helpful to estimate the lymphatic metastasis of laryngopharynx carcinoma.3.The IGF-1R expression was closely correlated with the u-PA expression,which suggested that IGF-1R and u-PA played a positive role to each other in course of pathogenesis, development, invasion and metastasis of laryngopharynx carcinoma.更多还原