【作者】 房宁；

【导师】 汪欣；

【作者基本信息】 吉林大学 ， 临床医学， 2010， 硕士

【摘要】 随着对喉癌研究的深入,逐渐认识到淋巴结转移和肿瘤局部复发是影响喉癌预后的主要因素。如何提高喉癌转移的早期诊断水平是及时正确处理颈部转移病灶的关键,有益于提高临床生存率。转录抑制因子Snail和上皮钙黏蛋白E-cadherin在上皮-间质转化(epithelial-esenchymal transition,EMT)过程中发挥着重要作用。Snail通过与E-cadherin启动子区的E-盒(E-box)结合,降低E-cadherin的表达进而诱导EMT的发生,从而促进肿瘤细胞从原发位置脱落,进而发生转移。国内外关于Snail和E-cadherin在肿瘤转移方面的研究,多致力于卵巢癌、结肠癌、食道癌等上皮性肿瘤的研究,尚未见两者在喉鳞癌方面的系统研究。本研究通过阐明Snail、E-cadherin在喉鳞癌、癌旁组织及息肉中的表达,来分析两者与喉鳞癌发生、发展的关系,并探讨Snail、E-cadherin在喉鳞癌中的表达与喉鳞癌患者临床病理各因素的关系,以及Snail、E-cadherin在喉鳞状细胞癌中表达的相关性。本实验通过免疫组织化学染色(S-P法)发现:Snail在喉鳞癌中的表达明显高于癌旁组织、声带息肉组织,而E-cadherin蛋白的表达与其相反;Snail的高表达与喉鳞癌的组织分化程度、颈淋巴结转移有关,E-cadherin表达的降低与喉鳞状细胞癌的组织分化程度、T分级、临床分期以及颈淋巴结转移有关;在喉鳞癌中Snail和E-cadherin的表达呈负相关,上述结果说明两者联合检测可作为喉鳞癌恶性程度和预后的参考指标,并可为个性化治疗提供参考信息。更多还原

【Abstract】 Purpose:To study the expression of Snail and E-cadherin in Laryngeal squamous cell carcinoma(LSCC)、normal squamous epidermis near cancer and polyp of vocal cord,and the relationship of the expression with the clinical pathology characteristics of LSCC, and also to understand the correlation between the expression of Snail and E-cadherin in LSCC.Methods:46 samples were cut off from surgical operations in the First Hospital of Jilin University from March 2008 to November 2009. 46 samples of normal squamous epidermis near cancer were selected, And 10 samples of polyp of vocal card were restored for contrast. The patients’age, sex, tumor position, T stage, clinical stage, differentiation and cervical lymph node matastasis were recorded. All samples were diagnosed by special pathologists. The pathological specimen was cut in the thickness of 4um. Streptavidin peroxidase(SP) immunohistochemistry staining for Snail and E-cadherin were made. The result of immunohistochemistry were determined by the intensity of staining and the number of positive cells. The expressions of Snail and E-cadherin in LSCC, normal squamous epidermis near cancer and polyp of vocal cord were analyzed. The relationship with the expression of Snail and E-cadherin with the clinical pathology characteristics were done. And the relevance of the expression of Snailand E-cadherin in LSCC was analyzed.Result:(1)The positive rate of Snail expression was 69.57%(32/46) in LSCC, in normal squamous epidermis near cancer was36.67%(17/46), and in polyp of vocal cord was 30.00%(3/10).The expression of Snail in LSCC was significantly higher than that in normal squamous epidermis near cancer and in polyp of vocal cord(P<0.05) . There was a significant correlation between the expression of Snail in LSCC with the differentiation and cervical lymph node matastasis (P<0.05).However There was no significant correlation between the expression of Snail with the patients’age, sex, tumor position, T stage , clinical stage(P>0.05).(2)The positive rate of E-cadherin expression was47.83%(22/46)in LSCC, and in normal squamous epidermis near cancer was78.3%(36/46), and in polyp of vocal cord was 90.0%(9/10). The expression of E-cadherin in LSCC was significantly lower than that in normal squamous epidermis near cancer and in polyp of vocal cord(P<0.05). There was a significant correlation between the expression of E-cadherin in LSCC with the T stage, clinical stage, cervical lymph node matastasis and differentiation (P<0.05).while There was no significant correlation between the expression of E-cadherin with the patients’age, sex and tumor position(P>0.05). (3)In LSCC, The expression of Snail was inversely correlated with expression of E-cadherin (r=-0.5690, P<0.01).Conclusion:(1)The expression of Snail was significantly increased in LSCC compared with in normal squamous epidermis near cancer and in polyp of vocal cord. Higher Snail expression was significantly associated with the differentiation and cervical lymph node matastasis (P<0.05). Higher Snail expression may imply more aggressive malignant behaviors of LSCC.(2)The expression of E-cadherin was significantly reduced in LSCC compared with in normal squamous epidermis near cancer and in polyp of vocal cord. Descending E-cadherin expression was significantly associated with the T stage, clinical stage, cervical lymph node matastasis and differentiation (P<0.05).Descending E-cadherin expression may imply more aggressive malignant behaviors of LSCC.(3)In LSCC, The expression of Snail and E-cadherin were negatively correlated.更多还原