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研究生:歐承眇
研究生(外文):Cheng-Miao Ou
論文名稱:CBAP作為卵巢上皮細胞癌的預後指標
論文名稱(外文):CBAP as a Prognostic Marker of Ovarian Epithelial Carcinoma
指導教授:曾麗慧曾麗慧引用關係李建南李建南引用關係鄭文芳鄭文芳引用關係
指導教授(外文):Li-Hui TsengJian-Nan LiWen-Fang Cheng
口試日期:2016-06-14
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:分子醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2016
畢業學年度:104
語文別:中文
論文頁數:45
中文關鍵詞:CBAP生物指標卵巢上皮細胞癌定量即時聚合酶連鎖反應聚合酶連鎖反應西方墨點法無病追蹤期整體存活期
外文關鍵詞:CBAPbiomarkerovarian epithelial carcinomaquantitative real-time PCRPCRwestern blotprogression free survivaloverall survival
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本論文的目的為研究分析CBAP基因表現量與卵巢上皮細胞癌(ovarian epithelial carcinoma)病人的臨床病理特徵之相關聯性,並探討CBAP是否可以用於評估卵巢上皮細胞癌的化療反應及作為預後指標。
本研究共收集257位病人的組織檢體,包含223位卵巢上皮細胞癌病人、24位良性卵巢腫瘤病人及10位停經後婦女且無卵巢病變,利用定量即時聚合酶連鎖反應(quantitative real-time polymerase chain reaction, QRT-PCR)、聚合酶連鎖反應(polymerase chain reaction,PCR)和西方墨點法(immunoblotting)偵測組織中CBAP的表現量,並記錄病人的臨床病理特徵及預後。
研究結果顯示,在卵巢上皮細胞癌病人的癌組織中,其CBAP基因的表現量高於良性及正常卵巢組織。在晚期、腫瘤細胞分化程度差及對化學治療有抗藥性的病人其癌組織中CBAP表現量相較於早期、腫瘤細胞分化程度佳及對化學治療有敏感性的病人為高。針對223位卵巢上皮細胞癌病患進行多變項分析(multi-variate analysis),發現疾病處於晚期、進行減積手術後殘餘腫瘤體積最大徑大(等)於一公分及癌化組織中CBAP表現高的病人,有較短的無病追蹤期(Progression free survival, PFS)及整體存活期(Overall survival, OS)。
總而言之,CBAP可以作為有發展潛能的生物指標用來預測卵巢上皮細胞癌化學治療反應及臨床預後。

The purpose of the study was to investigate the relationship between CBAP expression levels and the clinico-pathologic parameters of ovarian epithelial carcinoma patients. In addition, whether CBAP could be a biomarker of chemo-response and prognosis was also evaluated.
Totol 257 women were enrolled in the study, including 223 ovarian epithelial carcinoma patients, 24 benign ovarian epithelial carcinoma patients, and 10 menopausal women without definite ovarian lesions. The CBAP expressions were determined by Quantitative real-time polymerase chain reaction (QT-PCR), polymerase chain reaction (PCR), and immunoblotting respectively. The correlations between clinico-pathologic parameters and outcome of these ovarian patients were also analyzed.
The expression levels of CBAP were higher in cancerous tissues than those in benign ovarian and normal ovarian samples. Patients with advanced stages, high grade tumors, or chemo-resistance had significantly higher CBAP expression levels compared to those with early stages, low grade tumors, or chemo-sensitive. The advanced stages, residual tumor size ≥1cm after debucking surgery, and highly-expressing CBAP in cancerous tissues were independent poor prognostic factors for progression free survival (PFS) and overall survival (OS) by using multi-variate analysis.
In conclusion, CBAP can be a potential biomarker for predicting the chemotherapeutic responses and outcomes of ovarian epithelial carcinoma patients.


口試委員會審定書…………………………………………………………………… i
致謝…………………………………………………………………………………... ii
中文摘要……………………………………………………………………………. iii
英文摘要…………………………………………………………………………….. iv
第一章 前言…………………………………………………………………………. 1
第二章 材料與方法
2.1病人與樣本的蒐集………………………………………………………... 10
2.2檢體組織萃取RNA……………………………………………………….. 11
2.3反轉錄聚合酶連鎖反應…………………………………………………... 11
2.4即時定量聚合酶連鎖反應……………………………………………....... 12
2.5連鎖聚合酶反應………………………………………………………....... 12
2.6西方墨點法………………………………………………………............... 13
2.7統計分析………………………………………………………................... 14
第三章 實驗結果
3.1臨床資料特徵………………………………………………………........... 16
3.2以即時定量聚合酶連鎖反應偵測卵巢癌組織中CBAP基因表現量…… 16
3.3以連鎖聚合酶連鎖反應及西方墨點法偵測卵巢癌組織中CBAP表現… 17
3.4卵巢上皮細胞癌病人臨床特徵與組織中CBAP基因表現量分析……… 17
3.5卵巢上皮細胞癌病人的無病追蹤期之預後因子分析…………………... 18
3.6卵巢上皮細胞癌病人的整體存活期之預後因子分析…………………... 19
3.7卵巢上皮細胞癌病人的五年無病追蹤期(Progression free survival, PFS)
和整體存活期(Overall survival, OS)之存活曲線……………………….. 20
第四章 討論………………………………………………………........................... 21
參考文獻………………………………………………………................................. 25

附錄
表一 223位卵巢上皮細胞癌病人臨床病理特徵…………………........................ 36
表二223位卵巢上皮細胞癌病人臨床特徵與組織中CBAP基因表現量之
關連性…………………................................................................................... 37
表三 223位卵巢上皮細胞癌病人的無病追蹤期之預後因子分析........................ 38
表四 223位卵巢上皮細胞癌病人的整體存活期之預後因子分析........................ 39
圖一A1利用即時定量即時聚合酶連鎖反應分析卵巢上皮細胞癌組織中CBAP
基因的表現量…………………................................................................. 40
圖一A2利用即時定量聚合酶連鎖反應分析不同型態的卵巢上皮細胞癌組織中
CBAP基因的表現量…………………...................................................... 41
圖一A3 利用Mann Whiteney U test統計分析不同卵巢上皮細胞癌組織型態與正
常及良性卵巢腫瘤組織內CBAP基因表現量………………….............. 42
圖一B 利用聚合酶連鎖反應及西方墨點法分析不同病理的卵巢組織中CBAP
的表現量…………………......................................................................... 43
圖二 223位卵巢上皮細胞癌病人的五年無病追蹤期之存活曲線........................ 44
圖三 223位卵巢上皮細胞癌病人的五年整體存活期之存活曲線........................ 45


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