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随着影像学技术的进步,胰腺囊性病变(恶性胰腺囊性病变包括黏液性囊腺瘤(mucinous cystic neoplasm,MCN)和导管内乳头状黏液瘤(intraductal papillary mucinous neoplasm,IPMN)以及黏液性囊腺癌(mucinous cystic adenocarcinoma,MCA)的检出率有所提高,但是区分囊性病变的良恶性仍然是一个难题.本研究根据外科手术病理结果及囊液液基细胞结果,从120例经CT或MRI方法诊断为胰腺囊性肿瘤患者中选取35例样本,其中胰腺黏液性囊腺瘤(MCN)组17例与浆液性囊腺瘤(serous cystic neoplasm,SCN)组18例,通过超声内镜下细针穿刺(endoscopic ultrasonography-guided fine needle aspiration,EUS-FNA)方法吸取囊液,采用凝集素芯片分析蛋白质糖链谱差异.经t检验结果表明,MCN组与SCN组相比,6种凝集素,STL、WGA、BPL、DBA、PTL-Ⅰ及MAL-Ⅰ,识别的糖链结构二者之间存在明显差异(P<0.05),其中凝集素BPL、DBA、WGA、STL识别的糖链结构在MCN囊液中呈高表达(R>2.0),例如DBA特异识别的Tn抗原表达的增多,可能与肿瘤上皮细胞分泌的黏蛋白增多密切相关.而凝集素PTL-Ⅰ、MAL-Ⅰ特异识别Galβ-1、4Glc NAc结构以及Gal NAcα-1、3Gal结构在MCN囊液中表达降低(R<0.5).通过凝集素印记法检测了STL和BPL分别于MCN、SCN囊液中蛋白的结合情况,结果表明STL和BPL与囊液中的糖蛋白结合明显强于SCN组.本文通过比较MCN和SCN糖蛋白糖谱表达差异,寻找胰腺囊性肿瘤诊断和肿瘤良恶性评估的新方法,同时为探索胰腺囊性肿瘤发生发展机制和治疗的潜在靶点奠定基础.
With the progress of imaging technology, pancreatic cystic lesions (malignant pancreatic cystic lesions including mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN) and mucinous cysts The detection rate of mucinous cystic adenocarcinoma (MCA) has been increased, but it is still a difficult problem to distinguish the benign and malignant cystic lesions.Based on the results of surgical pathology and liquid-based liquid cystic fluid, 120 cases of CT Thirty-seven cases of pancreatic mucinous cystadenoma (MCN) and 18 cases of serous cyst neoplasm (SCN) were selected from 35 cases of patients with pancreatic cystic neoplasm by MRI. Cystic fluid was aspirated by endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) method, and the differences of protein glycan profiles were analyzed by lectin chip.The result of t-test showed that compared with SCN group, 6 kinds of agglutination There was a significant difference (P <0.05) in the structure of the sugar chains recognized by STL, WGA, BPL, DBA, PTL-I and MAL- Structure in MCN cyst fluid High expression (R> 2.0), such as the increased expression of Tn antigen recognized by DBA, may be closely related to the increase of mucin secreted by tumor epithelial cells.The lectins PTL-I and MAL-I specifically recognize Galβ-1,4GlcNAc Structure and the expression of GalNAcα-1,3Gal in MCN cyst fluid decreased (R <0.5) .The protein binding of STL and BPL in cyst fluid of MCN and SCN was detected by lectin method.The results showed that STL and BPL And the glycoprotein in cystic fluid was significantly stronger than that of SCN group.This article compared the expression of glycoprotein in MCN and SCN glycoprotein expression to find a new method for the diagnosis of pancreatic cystic neoplasm and benign and malignant tumor and in order to explore the occurrence of pancreatic cystic tumor Developmental mechanisms and treatment of potential targets to lay the foundation.