简介:该文是关于乳腺癌和细胞免疫类论文范文素材和乳腺癌有关学术论文怎么写.
[摘 要] 目的 探討血清神经生长因子（NGF）及细胞免疫水平在乳腺癌患者中的表达及其与临床病理特征的相关性. 方法 选择2015年3月～2018年2月在杭州市妇产科医院及浙江省舟山医院确诊的乳腺癌患者49例,设为观察组;选择同期入院的乳腺良性疾病患者45例,设为对照组;选择同期入院健康体检女性47名,设为正常组.采用酶联免疫吸附试验测定各组NGF表达水平;采用流式细胞仪测定各组CD3+、CD4+、CD8+及CD4+/CD8+水平;记录并统计患者临床病理资料,分析各组和观察组乳腺癌不同临床病理资料的NGF、细胞免疫水平;采用Pearson分析NGF、细胞免疫水平与乳腺癌患者临床病理资料的相关性. 结果 三组NGF、细胞免疫水平比较,差异均有统计学意义（P < 0.05）.观察组NGF水平高于对照组与正常组,且对照组NGF水平高于正常组,差异均有统计学意义（P < 0.05）.观察组CD3+、CD4+及CD4+/CD8+水平低于对照组与正常组,CD8+水平高于对照组与正常组,差异均有统计学意义（P < 0.05）;对照组与正常组CD3+、CD4+、CD8+及CD4+/CD8+水平比较,差异无统计学意义（P > 0.05）.乳腺癌组织中NGF、CD3+、CD4+、CD8+及CD4+/CD8+水平在年龄、病理组织学类型方面比较,差异无统计学意义（P > 0.05）;乳腺癌组织中NGF、CD3+、CD4+、CD8+及CD4+/CD8+水平在肿瘤最大径、病理分级、分化程度及淋巴结转移方面比较,差异均有统计学意义（P < 0.05）;Pearson相关性分析显示：NGF、CD8+水平与肿瘤最大径、病理分级、分化程度及淋巴结转移呈正相关（P < 0.05）;CD3+、CD4+及CD4+/CD8+水平与肿瘤最大径病理分级、分化程度及淋巴结转移呈负相关（P < 0.05）. 结论 NGF在乳腺癌患者中呈高表达,导致机体细胞免疫水平下降,且二者表达水平与病理特征具有相关性,加强NGF及细胞免疫水平测定能评估患者疾病严重程度,指导临床治疗.
[关键词] 血清神经生长因子;细胞免疫水平;乳腺癌;病理特征;相关性;酶联免疫吸附试验;流式细胞仪
[中图分类号] R737.9 [文献标识码] A [文章编号] 1673-7210（2020）04（b）-0088-05
Expression of serum nerve growth factor and cellular immunity in breast cancer and its correlation with clinicopathological feature
WANG Wenhui1WEN Yuanyuan2CHEN Hao1
1.Department of Pathology, Hangzhou Maternity Hospital, Zhejiang Province, Hangzhou310008, China; 2.Pathological Diagnosis Center, Zhejiang Zhoushan Hospital, Zhejiang Province, Zhoushan316021, China
[Abstract] Objective To investigate the expression of serum nerve growth factor （NGF） and cellular immunity in breast cancer patients and its correlation with clinicopathological feature. Methods A total of 49 breast cancer patients diagnosed in Hangzhou Maternity Hospital and Zhejiang Zhoushan Hospital from March 2015 to February 2018 were selected as the observation group. A total of 45 patients with benign breast disease who were hospitalized at the same time were selected as the control group. A total of 47 female patients with physical examination at the same time were selected as the normal group. The expression levels of NGF in each group were determined by enzyme-linked immunosorbent assay. The levels of CD3+, CD4+, CD8+ and CD4+/CD8+ in each group were determined by flow cytometry. The clinicopathological data of the patients were recorded and counted. The levels of NGF and cellular immunity in each group and the levels of NGF and cellular immunity in different clinicopathological data of breast cancer in the observation group were analyzed. The correlation between NGF, cellular immunity level and clinicopathological data of breast cancer patients was analyzed by Pearson analysis. Results The levels of NGF and cellular immunity in the three groups were statistically significant （P < 0.05）. The level of NGF in the observation group was higher than that in the control group and the normal group, and the level of NGF in the control group was higher than that in the normal group, with statistically significant differences （P < 0.05）. The levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were lower than those in the control group and the normal group, and the level of CD8+ was higher than that in the control group and the normal group, with statistically significant differences （P < 0.05）. There was no significant difference in the levels of CD3+, CD4+, CD8+ and CD4+/CD8+ between the control group and the normal group （P > 0.05）. The levels of NGF, CD3+, CD4+, CD8+ and CD4+/CD8+ in breast cancer tissues were not statistically significant differences in terms of age and histopathological type （P > 0.05）. The levels of NGF, CD3+, CD4+, CD8+ and CD4+/CD8+ in breast cancer tissues were compared in terms of tumor maximum diameter, pathological grading, differentiation degree and lymph node metastasis, with statistically significant differences （P < 0.05）. The Pearson correlation analysis results showed that the NGF and CD8+ levels were positively correlated with the maximum tumor diameter, pathological grading, differentiation degree and lymph node metastasis （P < 0.05）. The levels of CD3+, CD4+ and CD4+/CD8+ were negatively correlated with the maximum tumor diameter, pathological grading, differentiation degree and lymph node metastasis （P < 0.05）. Conclusion The high expression of NGF in breast cancer patients leads to the decline of cellular immunity level in the body, and the expression level of both is correlated with the pathology feature. Strengthening the determination of NGF and cellular immunity level can assess the severity of the disease in patients and guide clinical treatment.
[Key words] Serum nerve growth factor; Cellular immunity level; Breast cancer; Pathology feature; Correlation; Enzyme-linked immunosorbent assay; Flow cytometry
乳腺癌是发生在乳腺腺上皮的恶性肿瘤,在乳腺癌患者中女性发生率占99.0%,男性发生率仅占1.0%[1].乳腺癌患者随着癌细胞的不断增殖、生长,细胞间的黏附性下降,细胞易脱离[2],游离的癌细胞会随着血液、淋巴结散播到全身,威胁患者生命[3].目前,乳腺癌发病机制尚不完全知晓,认为生物学因子改变、基因改变是促进乳腺上皮细胞恶变的主要原因[4].血清神经生长因子（NGF）对促进神经纤维形成有重要的生理学意义,其异常表达能增加癌变风险,导致癌细胞发生侵袭、转移[5].研究表明[6-7]：NGF及细胞免疫水平与乳腺癌患者预后相关,可以预测疗效,且与病理具有相关性,能为临床诊疗提供依据.因此,本研究以乳腺癌患者、乳腺良性疾病患者及健康体检女性作为研究对象,探讨NGF及细胞免疫水平在乳腺癌患者中的表达及其与病理的相关性.
1 资料与方法
1.1 一般资料
选取2015年3月～2018年2月杭州市妇产科医院及浙江省舟山市医院的乳腺癌患者49例作为研究对象,设为观察组,平均年龄（45.69±5.61）岁;平均肿瘤大小（5.69±1.04）cm.选取同期入院的乳腺良性患者45例（乳腺炎11例,乳腺增生癥34例）,设为对照组,平均年龄（47.86±4.61）岁.选取同期入院健康体检女性47名,设为正常组.
1.2 纳入及排除标准
纳入标准：①经病理组织检查确诊为乳腺癌、乳腺良性病变;②对患者的诊断、检查均在医嘱下完成.排除标准：①合并其他部位恶性肿瘤或预计生存期<3个月者;②精神异常或伴有其他脑血管疾病者;③入院前行放化疗或免疫治疗者.
1.3 方法
①标本采集.观察组与对照组入院后次日早晨取空腹静脉血5 mL,正常组健康体检当天取空腹静脉血5 mL,台式离心机TDZS-W5（湖南湘仪医疗仪器有限公司）,离心20 min,离心半径60 mm,速度4500 r/min,血清分离完毕后放置在-20℃冰箱中,备用;②检测方法.采用酶联免疫吸附试验测定NGF水平（NGF试剂盒试剂购自上海基因科技有限公司,批号：20160219）;采用流式细胞仪（Facs Calibur美国BD公司）测定各组CD3+、CD4+、CD8+及CD4+/CD8+水平,检测操作均遵循仪器、试剂盒步骤完成[8-9];③病理组织.记录并统计乳腺癌患者病理资料,包括：肿瘤最大径、病理组织学类型、病理分级、分化程度、淋巴结转移等,分析不同病理组织下NGF、细胞免疫水平表达水平.
1.4 统计学方法
采用SPSS 18.0对所得数据进行统计学分析,计量资料采用均数±标准差（x±s）表示,组间比较采用t检验,多组采用方差分析,组内两两比较采用SNK-q检验,采用Pearson相关进行相关性分析.以P < 0.05为差异有统计学意义.
2 结果
2.1 三组NGF、细胞免疫水平比较
三组NGF、细胞免疫水平比较,差异均有统计学意义（P < 0.05）.观察组NGF水平高于对照组与正常组,且对照组NGF水平高于正常组,差异有统计学意义（P < 0.05）.观察组CD3+、CD4+及CD4+/CD8+水平低于对照组与正常组,CD8+水平高于对照组与正常组,差异有统计学意义（P < 0.05）;对照组与正常组CD3+、CD4+、CD8+及CD4+/CD8+水平比较,差异无统计学意义（P > 0.05）.见表1.
2.2 观察组乳腺癌不同临床病理资料的NGF、细胞免疫水平比较
乳腺癌组织中NGF、CD3+、CD4+、CD8+及CD4+/CD8+水平在年龄、病理组织学类型方面比较,差异无统计学意义（P > 0.05）;乳腺癌组织中NGF、CD3+、CD4+、CD8+及CD4+/CD8+水平在肿瘤最大径、病理分级、分化程度及淋巴结转移方面比较,差异有统计学意义（P < 0.05）.见表2.
2.3 乳腺癌不同病理资料的NGF、细胞免疫水平相关性分析
Pearson相关性分析结果显示：NGF、CD8+水平与肿瘤最大径、病理分级、分化程度及淋巴结转移呈正相关（P < 0.05）;CD3+、CD4+及CD4+/CD8+水平与肿瘤最大径、病理分级、分化程度及淋巴结转移呈负相关（P < 0.05）.见表3.
3 讨论
乳腺癌病因相对复杂,常伴有生物学或基因学水平异常[10].国内学者研究表明[11],当机体相关指标、免疫水平发生异常后,将会影响肿瘤细胞DNA发生转录导致其调控的基因表达异常,影响癌细胞增殖分化,从而加剧疾病的发生发展.因此,加强乳腺癌患者生化指标、细胞免疫水平研究能为乳腺癌基因及生物治疗提供依据和参考[12].
NGF是蛋白酶家族重要成员之一,能直接参与乳腺癌的发生、发展,能激活PI3K/Akt、P53等信号通路,从而能加剧肿瘤的发生、发展[13].国内学者研究表明[14],NGF除了参与乳腺癌的发生、发展外,还能影响乳腺癌表面蛋白的糖蛋白配体活性,降低癌细胞间的黏附能力,从而为恶性肿瘤的转移提供条件.本研究中,观察组NGF水平均高于对照组与正常组（P < 0.05）;对照组NGF水平高于正常组（P < 0.05）;观察组CD3+、CD4+及CD4+/CD8+水平低于对照组与正常组（P < 0.05）;观察组CD8+水平高于对照组与正常组（P < 0.05）.可见NGF在乳腺癌患者中呈高表达,引起机体免疫水平下降,加剧疾病的发生发展.数据调查表明[15],在乳腺癌患者中NGF表达浓度能上升26.0%～36.0%,并且患者治疗敏感性越差、生存指标越低,NGF表达水平越高.
乳腺癌的发生发展是一个多因素过程,常伴有细胞免疫水平的变化[16-17].研究表明[18-19],肿瘤患者外周血肿细胞免疫水平常呈低表达.CD4+T细胞能调控局部炎症与细胞毒相关的免疫应答,能促进机体产生抗体;此外,CD4+T细胞还能活化自然杀伤细胞与巨噬细胞,提高巨噬细胞的杀伤能力;CD8+T细胞毒性相对较轻,在杀死肿瘤细胞中发挥了重要的作用.研究表明[20-21],细胞免疫对于肿瘤免疫反应的抑制能在淋巴组织中表现,能种植效应细胞活化阶段,改变肿瘤的微环境,从而干扰机体正常的抗肿瘤免疫应答,抑制肿瘤细胞的清除.乳腺癌患者中细胞免疫水平受影响因素较多,包括肿瘤的分期、肿瘤大小、分化程度等.本研究中,分析结果显示：NGF、CD8+水平与肿瘤最大径、病理分级、分化程度及淋巴结转移呈正相关（P < 0.05）;CD3+、CD4+及CD4+/CD8+水平与肿瘤最大径、病理分级、分化程度及淋巴结转移呈负相关（P < 0.05）.可见乳腺癌患者中细胞免疫水平与病理表现存在相关性.为了提高乳腺癌患者诊断、治疗效果,可加强患者NGF和细胞免疫水平测定,评估患者疾病严重程度;对于确诊的乳腺癌患者尽早给予手术、放化疗等治疗,且治疗过程中加强患者NGF和细胞免疫水平测定能评估患者预后,可以视检测结果调整治疗方案,使得患者的治疗更具科学性[22].
综上所述,NGF在乳腺癌患者中呈高表达,导致机体细胞免疫水平下降,且二者表达水平与病理表现具有相关性,加强NGF及细胞免疫水平测定能评估患者疾病严重程度,指导临床治疗.
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（收稿日期：2019-08-21 本文编辑：顾家毓）
总结：此文结束语,此文是一篇关于对写作乳腺癌论文范文与课题研究的大学硕士、乳腺癌和细胞免疫本科毕业论文乳腺癌和细胞免疫论文开题报告范文和相关文献综述及职称论文参考文献资料有帮助.
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