早期透明細(xì)胞腎細(xì)胞癌轉(zhuǎn)移的相關(guān)因素分析.pdf

1、分類號：R737密級：不保密UDCUDC：610學(xué)校代碼：11065碩士學(xué)位論文早期早期透明細(xì)胞腎細(xì)胞癌轉(zhuǎn)移的相關(guān)因素分析透明細(xì)胞腎細(xì)胞癌轉(zhuǎn)移的相關(guān)因素分析褚菁指導(dǎo)教師李玉軍主任醫(yī)師學(xué)科專業(yè)名稱病理學(xué)與病理生理學(xué)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