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目的 :研究成人喉乳头状瘤复发的相关因素。方法 :收集成人喉乳头状瘤复发标本 5 0例 ,另选 10例炎症病变黏膜组织作为对照。应用SP法检测石蜡标本中耐药基因胎盘型谷胱甘肽 S 转移酶 (GST π)、DNA拓朴酶Ⅱ (TopoⅡ )、P 糖蛋白 (Pgp)和Ki 6 7、血管内皮生长因子 (VEGF)的表达 ,并用形态计量方法检测肿瘤内微血管密度 (MVD) ,对所得的各项指标进行统计学分析。结果 :①耐药基因Pgp、GST π和TopoⅡ的表达与年龄、性别、肿瘤大小及肿瘤复发无显著相关 (P >0 .0 5 )。②Ki 6 7在复发肿瘤与非复发肿瘤组织之间差异有统计学意义 (P <0 .0 1)。多元回归分析显示该指标是肿瘤复发的独立危险因素之一 ,以 39%为分界点 ,大于 39%者容易复发。③MVD >19(× 2 0 0 )的成人喉乳头状瘤比 <19的成人喉乳头状瘤容易复发。结论 :用Cox 逐步回归模型进行多因素分析 ,筛选出了与成人喉乳头状瘤复发有密切关系的 5个指标 :Ki 6 7阳性率是最重要的复发因子 ,其次为MVD ,而肿瘤耐药因子Pgp、TopoⅡ、GST π无明显意义。
Objective: To study the related factors of recurrent laryngeal papilloma in adults. Methods: Fifty adult recurrent laryngeal papilloma samples were collected, and the other 10 inflammatory tissues were selected as control. SP method was used to detect the expression of GST π, Topo Ⅱ, Pgp and Ki 6 7, vascular endothelial growth factor (VEGF) ), And the intracranial microvessel density (MVD) was measured by morphometry. Statistical analysis was made on each index obtained. Results: ① The expressions of Pgp, GST π and Topo Ⅱ were not related to age, sex, tumor size and tumor recurrence (P> 0.05). ②Ki 6 7 in recurrent tumors and non-recurrent tumor tissue differences were statistically significant (P <0.01). Multivariate regression analysis showed that the index was one of the independent risk factors of tumor recurrence. With 39% as the cut-off point, the index of recurrence was more than 39%. ③ MVD> 19 (× 200) adult laryngeal papilloma than <19 laryngeal papilloma easily recurred. Conclusion: Cox stepwise regression model was used for multivariate analysis to screen out 5 indicators closely related to the recurrence of adult laryngeal papilloma: the positive rate of Ki 6 7 was the most important recurrence factor, followed by MVD, and the tumor resistance Factors Pgp, Topo Ⅱ, GST π no significant meaning.