【作者】 周彬；

【导师】 李鹤成；

【作者基本信息】 上海交通大学 ， 外科学， 2019， 硕士

【摘要】 目的:研究多灶食管鳞癌患者的临床特征及预后。方法:回顾性收集我院胸外科2014-2018食管鳞癌病人的临床资料,提取比较多灶与单灶食管患者的临床及病理资料,发现其特征;将两组食管癌患者进行倾向评分匹配,平衡组间变量,分析多灶对食管癌预后的影响。结果:多灶食管鳞癌的发病率较低,本研究中比例仅为3.8%;部分患者多病灶间分化程度不同,且病灶之间相距最远可达7cm;多灶食管鳞癌患者与单灶患者临床分期有显著差异,多灶食管癌患者更易发生淋巴结转移,临床分期偏晚;倾向匹配后的多灶食管癌患者与单病患者的预后无明显差异。结论:多灶食管癌发病率较低,不同病灶间起源可能不同;尽管多病灶食管鳞癌更易发淋巴结转移及临床分期较晚,但食管鳞癌的病灶数目可能对患者生存时间影响并没有显著影响。背景:肺癌是全世界最常见的癌症相关的死亡病因之一,而肺鳞癌生存率较低且是肺癌的主要病理类型之一。目前已有较多的肺鳞癌基因表达相关分析,但很少有人关注细胞周期相关基因的临床意义。方法:我们研究了肺鳞癌患者中细胞周期相关基因的表达模式。我们从c Bioportal网站下载了TCGA肺鳞癌患者的细胞周期相关基因m RNA表达和临床数据。我们进行了一系列的分析,以探究这些基因与肺鳞癌之间的关系。结果:我们根据124个细胞周期相关基因的m RNA表达模式做出了3个分组。其中组3预后最差。差异基因分析表明,有9个基因的表达在不同的分组中有明显的差异;对这9个基因的表达和患者的预后进行分析,结果显示高表达的CDK4与较好预后显著相关。此外,我们还发现ANAPC11、ANAPC5和ORC4基因表达与肺鳞癌病理分期进展相关。结论:本研究揭示了不同的肺鳞癌亚群中细胞周期的基因表达模式,并表明个别基因与预后和分期有关。这些结果为肺鳞癌的预后策略的制定、患者危险程度的分层和靶向治疗的位点提供了新的依据。更多还原

【Abstract】 Objective: To study the clinical characteristics and prognosis of multifocal esophageal squamous cell carcinoma.Methods: The data of patients with esophageal squamous cell carcinoma in our department from 2014 to 2018 were retrospectively collected.The clinical and pathological data of patients with multiple and single esophageal lesions were extracted and compared,and their characteristics were revealed.The prognosis of esophageal cancer was analyzed by propensity score matching between the two groups,balancing the variables between groups.Results: The incidence of multifocal esophageal squamous cell carcinoma was low,the proportion in this study was only 3.8%.Some patients had different degrees of differentiation among multiple lesions,and the furthest distance between lesions was as far as 7 cm.The clinical stages of multifocal esophageal squamous cell carcinoma patients were significantly different from those of single-focus patients.The patients with multifocal esophageal cancer were more likely to have lymph node metastasis and the clinical stages were advanced than those of single-focus patients.There was no significant difference in the prognosis of two groups after matching.Conclusion: The incidence of multiple esophageal squamous cell carcinomas was low and different lesions may have different origins.Although multiple esophageal squamous cell carcinomas are more likely to have lymph node metastasis and relatively advanced clinical stages,the number of lesions of esophageal squamous cell carcinomas may have no significant impact on the survival time of patients.Background: Lung cancer is one of the most common cancer-related death causes in the world.Lung squamous cell carcinoma has a low survival rate and is also one of the main pathological types of lung cancer.At present,there are many related analysis of gene expression in lung squamous cell carcinoma,but few people pay attention to the clinical significance of cell-cycle-associated genes.Methods: We studied the expression patterns of cell cycle related genes in patients with lung squamous cell carcinoma.We downloaded the expression of TCGA gene expression and clinical data from the cbioportal website.We conducted a series of analyses to explore the relationship between these genes and lung squamous cell carcinoma.Results: Three groups were divided according to the expression patterns of 124 cell-cycle-associated genes.Group 3 had the worst prognosis.Differential gene analysis showed that there were significant differences in the expression of 9 genes in all different groups.The expression of 9 genes and the prognosis of patients were analyzed.The results showed that high expression of CDK4 was significantly correlated with better prognosis.In addition,we also found that the expression of ANAPC11,ANAPC5 and ORC4 genes were associated with the progression of pathological stages of lung squamous cell carcinoma.Conclusion: This study reveals the gene expression patterns of cell cycle in different lung squamous cell carcinoma subpopulations,and indicates that individual genes are related to prognosis and stage.These results provide a new basis for the formulation of prognostic strategies,risk stratification and targeted therapy options for lung squamous cell carcinoma.更多还原