早期透明細胞腎細胞癌轉移的相關因素分析.pdf

1、分類號：R737密級：不保密UDCUDC：610學校代碼：11065碩士學位論文早期早期透明細胞腎細胞癌轉移的相關因素分析透明細胞腎細胞癌轉移的相關因素分析褚菁指導教師李玉軍主任醫(yī)師學科專業(yè)名稱病理學與病理生理學論文提交日期2016年04月17日論文答辯日期2016年05月28日答辯委員會主席韓博教授AbstractObjectiveTodetecttheclinicopathologicalfeaturestheessentialso

2、fdiagnosisdifferentialdiagnosisofmetastaticccRCC.ToidentifyaberrantlyexpressedEMTmarkersinearlylocalizedclearcellrenalcellcarcinomas(ccRCCs)toevaluatetheirprognosticvaluesfpredictingpostoperativemetastasis.MethodsImmunoh

3、istochemicalstainingwascarriedoutontissuemicroarraytodetecttheexpressionfeaturesofSnailCD151SlugTwistCMTM8PDL1in58instancesofearlylocalizedccRCC(pT12)including22instancesdevelopingmetastasisduringafollowupperiodof3years3

4、6instanceswithoutmetastaticdiseasewithin3years.Themetastasisfreesurvival(MFS)wascalculatedtoinvestigatethepotentialprognosticvaluesoftheestablishedmarkers.Results1.Thecohtcomprisedofmemalesthanfemales.Amongthe42casesmeta

5、staticccRCC19casesmetastasizedtothelung8casesmetastasizedtothebone.ThepredominanthistologicpatternofmetastaticccRCCswasacterizedbythepresenceofsmallnestinterstitialcapillariesclusteredhyperplasia.ImmunohistochemicallyCD1

6、0vimentinCAⅨPAX8RCCEMAproteinwereexpressedinthemetastasisfociindifferentdegreeswiththeexpressionratesof39（92.9%）40（95.2%）38（90.5%）38（90.5%）31（73.8%）38(90.5%)respectively.2.Tumsizenucleolusgradenecrosisareassociatedwithme

7、tastaticpotentialofearlylocalizedccRCCs.Thelargertumthehighernucleolusgrademenecrosisthehighermetastaticpotential(P0.05).4.PrimaryccRCCsdevelopingmetastasisin3yearsbearhigherpositiveratesthantheircounterpartswithoutmetas

8、tasis(Snail40.9%vs.11.1%CD15172.7%vs.30.6%)(P0.05).5.FurthersurvivalanalysisdemonstratedthathighSnailCD151expressionswereassociatedwithpostoperativeMFSinpatientswithearlylocalizedccRCCs.Nucleolusgradetumnecrosisweretwoin