【作者】 张晓红；

【导师】 张爱臣；

【作者基本信息】 吉林大学 ， 临床医学， 2006， 硕士

【摘要】 Ki-67即细胞核相关抗原(nuclear-associated antigenki-67)是一种与细胞增殖密切相关的核抗原,在增殖细胞中表达,而在静止细胞中则不表达,Ki-67的异常表达反映了肿瘤细胞的增殖活性。EGFR即表皮生长因子受体(EpidermalGrowth Factor Receptor, EGFR)是存在于细胞表面的跨膜糖蛋白分子,在生理状态下是细胞的生长调节因子,过度表达的EGFR干扰细胞分化的正常调控状态,引起细胞持续增殖,发生恶性转化。近年的研究证实Ki-67和EGFR是两个与细胞周期密切相关的调节因子,与卵巢癌的发生、发展、分期、转移、预后、复发和生存期存在密切的关系。本文应用免疫组织化学方法研究Ki-67和EGFR在正常卵巢组织、良性卵巢肿瘤组织及卵巢癌组织标本中的表达情况。结果发现,Ki-67和EGFR在正常卵巢组织中无表达,在良性卵巢肿瘤组织中低水平表达,在卵巢癌组织中高水平表达。在卵巢癌组织中阳性表达与卵巢癌的病理类型无关,与卵巢癌的组织学分级及临床分期有关,与卵巢癌患者的预后、复发和生存期有关。Ki-67和EGFR共同阳性表达率随着病变程度加重而增高,说明二者在肿瘤发生和发展中呈协同作用,表现出一致的正相关性。由此推论,通过检测Ki-67和EGFR在卵巢癌组织中的表达情况,分析其与卵巢癌的发生、发展的关系,可以判断卵巢癌的恶性程度及估计其预后。更多还原

【Abstract】 Objective :To study the expression of Ki-67 and epidermalgrowth factor receptor(EGFR) in the tissue of normalovarian,benign ovarian and ovarian cancer and to explorethe correlation between the expression of EGFR andKi-67and the ovarian cancer status, includingpathological types ,clinical stage and differentiation,and prognosis.Methods: To select randomly 90 cases of ovarian specimenwho were operated at the Department of Obstetrics andGynecology at the China-Japan Union Hospital of JilinUniversity in 2003-2006. All the specimens of ovariancancer were selected from the tissues without adjuvantradiotherapy and chemotherapy,including 15 cases ofnormal ovarian tissue,15 cases of benign ovarian tumorand 60 cases ovarian cancer ,which were divided intoseveral groups according to pathological types,clinical stage and differentiation. The expression ofEGFR and Ki-67 were detected by immunohistochemistricalSP method. Results of the reactions and analysis of theclinical course of the patients were subjected tostatistical analysis.Result: ①Both Ki-67 and EGFR were negatively expressedin normal ovarian tissues . ②The positive rates of Ki-67and EGFR were 33.3%、40.0% in ovarian benign tumor,and were 75.0%、80.0% in ovarian cancer, respectively.The normal ovarian tissues group and the ovarian benigntumor group differed significantly by the expression ofKi67 and EGFR . And both groups significantly differedfrom the ovarian cancer group. A significant positivecorrelation was found between the expression of Ki67 andEGFR in the ovarian cancer group. The expression of Ki-67and EGFR were significantly higer in ovarian cancer thanin ovarian benign tumor. There was significant differencebetween two groups statistically(p<0.05).The browngranules of EGFR positive cell were mainly distributed incytomembrane and cytoplasm, but the brown granules ofKi-67 positive cell were mainly distributed in nuclei .③There were a significant positive correlation betweenthe expression of Ki-67 or EGFR and the clinical stage.The positive rates of Ki-67 and EGFR in ovarian cancerclinical stageⅠ/Ⅱ were 60.8%、65.2%,that in clinicalstageⅢ / Ⅳ were 83.8%、89.1%respectively. Thepositive rates of Ki-67 and EGFR were significantly higerin those with clinical stageⅢ /Ⅳtumors than those withclinical stageⅠ/Ⅱ. There was significant differencebetween two groups statistically(p<0.05) .④The positiverates of Ki-67 and EGFR in ovarian cancer welldifferentiation and moderately differentiation were 54.5%、59.1%,that in poorly differentiation were86.8%、92.1%, respectively. The positive rates of Ki-67 and EGFRwere significantly higer in poorly differentiation thanin well differentiation and moderately differentiation.There was significant difference between two groupsstatistically(p<0.05). ⑤The positive rates of Ki-67 andEGFR in serous cystadenocarcinoma were 73.3%、83.3%,that in non-serous cystadenocarcinoma were 76.0%、76.6%, there was no significant difference between two groupsstatistically(p>0.05).⑥There was a positive correlationbetween the positive rates of EGFR and the positive ratesof Ki-67.⑦EGFR and Ki-67 were correlated with prognosisof ovarian cancer.Conclusions:1 .Ki-67 and EGFR were negatively expressed in normalovarian tissue and were low expressed in ovarian benigntumor and were high expressed in ovarian cancer.2 .The more later in clinical stage and the more poorerin cell differentiation, the more higher positiverates of Ki-67 and EGFR were .The positive rates ofKi-67 and EGFR were correlated withhistodifferemtiation and clinical stages of ovariancancer , but were uncorrelated with the pathologicaltype.3 .The much higher the positive rates of Ki-67and EGFRwere, the much worse the ovarian cancer became. Theexpression of Ki-67 and EGFR were positivelycorrelated with the development of ovarian cancer.4 .We judge malignant degree of the tumor and estimateovarian cancer prognosis on the basis of positiveexpression rate. We still need to further study theKi-67 and EGFR and signal transduction path, revealgrowth molecule mechanism regulated by Ki-67 and EGFR,it will provide new way of future gene therapy forovarian cancer.更多还原