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研究生:顏昆山
研究生(外文):Kun-Shan Yen
論文名稱:罹患神經母細胞瘤之兒科病人的病毒感染及病毒蛋白表現的作用-PVB19,EBV,EV71和CMV的檢測與臨床意義
論文名稱(外文):Virus infection in pediatric patients with neuroblastoma and the effect of viral gene expression- Detection and the clinical significance of PVB19, EBV, EV71 and CMV
指導教授:陳昇明陳昇明引用關係周寬基周寬基引用關係
指導教授(外文):Tschen, J. S-MKuan-Chih Chow
學位類別:碩士
校院名稱:國立中興大學
系所名稱:生命科學院碩士在職專班
學門:生命科學學門
學類:生物學類
論文種類:學術論文
論文出版年:2002
畢業學年度:90
語文別:中文
論文頁數:69
中文關鍵詞:神經母細胞瘤微小病毒B19原型腫瘤基因N-myc子癲原位雜交神經外胚層流式細胞儀DNA含量
外文關鍵詞:NeuroblastomaPVB19N-myceclampsiaISHectodermflow cytometryDNA content
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罹患神經母細胞瘤的兒科病人,尤其是罹患stage IVs神經母細胞瘤者,某些伴隨著非常嚴重的貧血,卻檢測不出神經母細胞瘤已侵犯骨髓;有時病情來勢洶洶,尤其是腫瘤細胞中可偵測到N-myc基因增幅者,診斷時腫瘤細胞即可能已在腹腔四處擴散並已侵犯大部分的肝臟。但是,某些這種病患,特別是腫瘤細胞中N-myc基因沒增幅者,即使在沒有治療的狀況下卻可能有自然恢復的現象,即腫瘤細胞會自動消退,但原因仍待進一步的證實與探討。可是,這些病人在其病情最嚴重的時候,骨髓內紅血球母細胞形態上的改變顯示可能與病毒感染有關。但是關於病毒來源的研究,現有的資訊仍非常有限,其中最重要的是,病毒感染與喚醒其後天之免疫作用是否有關,更需要深度的認識。因此,為更進一步了解罹患神經母細胞瘤之兒科病人的病毒感染及病毒蛋白表現的作用,本研究的目的在檢驗罹患神經母細胞瘤及貧血之兒科病人與微小病毒B19 (PVB19)、Epstein-Barr Virus (EBV)、腸病毒71型(EV 71)和巨細胞病毒(CMV)的關係,以及病毒蛋白表現對這些病人的作用與臨床意義。

In pediatric patients with neuroblastoma, in particular, those with stage IVs neuroblastoma, sometimes the disease was combined with severe anemia. However, no tumor involvement was detected in the bone marrow. Although some of these patients may have N-myc gene amplification, and the disease could have invaded many abdominal organs, especially liver, interestingly, the disease might regress spontaneously in some of these patients. The medical reason of the spontaneous regression, nonetheless, remains to be determined. It is worth noting that morphological changes of erythroid progenitor cells in the bone marrow have suggested virus infection in these pediatric patients. However, the available information of viral origin is limited. Furthermore, it is possible that the virus infection in these patients could be associated with the revocation of immune responses related to the spontaneous regression of the tumor. In this study we will investigate the relationship of parvovirus B19 (PVB19), Epstein-Barr virus (EBV), enterovirus 71 (EV71) and cytomegalovirus (CMV) with neuroblastoma by PCR in Taiwanese pediatric patients. Moreover, we will study the effect and the clinical significance of viral gene expression as well as N-myc gene amplification in these patients.

目 錄 頁數
口試委員會審定………………………………………………… Ⅰ
博碩士論文電子檔案上網授權書……………………………… Ⅱ
誌謝…………………………………………………………... Ⅲ-Ⅳ
表目錄…………………………………………………………… Ⅶ
圖目錄…………………………………………………………… Ⅷ
中文摘要………………………………………………………… 1
英文摘要………………………………………………………… 2
前言……………………………………………………………… 3-4
文獻探討………………………………………………………… 5
第一章 流行病學…………………………………………….. 5
第一節 發生率…………………………………..………. 5
第二節 危險因子……………………………………..…. 5
第二章 分子病理的發生…………………………………….. 5
第一節 DNA含量……………………………………….. 5-7
第二節 N-myc的增幅………………………………...… 7-8
第三節 染色體的增加或缺失..…………………………. 8-10
第四節 異常染色體……………………………………. 10-11
第五節 發病或轉移相關基因及蛋白質………………. 12-14
第六節 其它相關因子………………………………… 14-15
第三章 原形腫瘤基因c-myc,N-myc與細胞凋亡之關係…15-16
第四章 預後標記…………………………………………… 17
第一節 血清標記…………………………………….… 17
第二節 尿液標記…………………………………….… 17
第五章 腫瘤相關遺傳標記………………………………… 18
第六章 危險因子的多變異分析…………………………… 18
第七章 診斷期別……………………………………….. 18-19
第八章 診斷及評估………………………………………… 19
第九章 分期系統…………………………………………… 19
材料與檢體…………………………………………………….. 24
分析方法……………………………………………………. 20-24
結果………………………………………………………… 25-29
討論………………………………………………………… 30-33
結論………………………………………………………… 34-36
參考資料…………………………………………………… 46-65
表目錄 頁數
【表1】罹患神經母細胞瘤之兒科病人的臨床特徵、聚合?A鏈鎖反
應及原位雜交結果……………………………………….. 44
【表2】NS1序列和Papillomavirus及ATPase的比較………….45
圖目錄 頁數
【圖1A】帶有preeclampsia/eclampsia和貧血並換血紅素之波動數據
表…………………………………………………………... 37
【圖1B和C】暫時性微小病毒B19病毒血症出現於帶有
preeclampsia/eclampsia及貧血病人中……….... 38
【圖2】超音波、斷層攝影及核磁共振顯示出神經母細胞瘤multifocal
的存在………………………………………………………... 39
【圖3】經由病理組織學診斷神經母細胞瘤的圖像(×200)… 40
【圖4】以原位雜交法呈現之微小病毒B19存在於神經母細胞瘤中
的圖像……………………………………………………... 41
【圖5】在骨髓中,於後續不同的日期呈現微小病毒B19訊號的出
現及活化的capase 3……………………………………… 42
【圖6】罹患神經母細胞瘤的病人經由螢光原位雜交法偵測N-myc
的增幅……………………………………………………... 43

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