【作者】 朱卫平；

【导师】 马保金；

【作者基本信息】 复旦大学 ， 外科学， 2011， 硕士

【摘要】 背景与目的胆囊癌是高度恶性的肿瘤,早期诊断困难,目前尚无有效的防治方法,发现一些可用于肿瘤的早期诊断、监测扩散转移的生物学指标具有重要意义。本课题主要通过研究survivin和Cyclin D1在慢性结石性胆囊炎、胆囊腺瘤及胆囊癌组织中的表达情况,分析两者相关性,初步探讨胆囊癌的发病机理,为早期检测和治疗,监测预后提供理论依据。方法应用免疫组织化学法检测40例胆囊癌,10例慢性结石性胆囊炎及9例胆囊腺瘤患者的病理组织切片中survivin, Cyclin D1的表达情况。分析survivin, Cyclin D1表达与临床病理行为的关系,同时分析两者表达的相关性。结果①Survivin在胆囊癌组织中阳性表达率为67.5%(27/40),显著高于胆囊良性病变组织(P<0.05); Cyclin D1在胆囊癌组织中阳性表达率为55%(22/40)显著高于慢性胆囊炎(P<0.05),与胆囊腺瘤无显著差异性(P>0.05);②Survivin, Cyclin D1的表达与性别、年龄、组织学类型、淋巴结转移、Nevin分期无关(P>0.05)。Survivin和Cyclin D1的表达与胆囊癌患者的预后明显相关(P<0.05)。③Survivin和Cyclin D1表达呈正相关(r=0.414,P=0.003)结论Survivin和Cyclin D1的过表达在胆囊癌的发生、发展中起重要作用。survivin和Cyclin D1蛋白表达升高可作为原发性胆囊癌的独立预后指标。更多还原

【Abstract】 Background and Objective:Gallbladder carcinoma(GBC) is a highly malignant neoplasm and difficult in early diagnosis. There is no effective prevention and cure method yet at present. It is significant to find some biological markers used in early diagnosis, monitor recrudescence and metastasis. This study evaluated the roles of survivin and cyclin D1 in GBC and their interaction in order to explain the mechanism of carcinogenesis of GBC, furtherly to provide theoretical foundation for prevention and clinical treatment.Methods:The expression of survivin and cyclin D1 were examined by method in immunohistochemical tissue samples from 40 cases of GBCs,9 cases of adenoma gallbladder and 10 cases of chronic caculous cholecystitis.Analyse the interaction between clinic pathological parameters and the inner relationship of survivin and cyclin D1 in GBC.Results:(1). Positive cytoplasmic immunoreactivity was detected in a proportion of 67.5% for survivin, and 55% for cyclin D1 in GBC, respectively. There was a significant difference in malignant lesion than in benign diseases for survivin(P<0.05). And there was also a significant difference for cyclin D1 between malignant lesion and chronic caculous cholecystitis(P<0.05). But there was no significant difference in malignant lesion and gallbladder adenoma for cyclin D1 (P>0.05). (2). The expression level of survivin and cyclin D1 protein in gallbladder carcinomas were not markedly associated with patient’s sex, age, histological types, lymph node metastasis and nevin’s stage (P>0.05). Log rank test showed that the survivin and cyclin D1 expression were significantly related with prognosis of the patients (P<0.05). (3). The expression of survivin correlated positively with cyclin D1 expression(r=0.414, P=0.003).Conclusions:The over-expression of survivin and cyclin D1 play an important role in the care i nogenesis and progression of GBC. Increased survi vin and cyclin Dl expression in GBC were significantly related with prognosis, and be dependent prognostic marker.更多还原