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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 鄭世榮(Shih-Jung Cheng) | |
| dc.contributor.author | Nai-chi Chi | en |
| dc.contributor.author | 紀乃齊 | zh_TW |
| dc.date.accessioned | 2021-06-17T03:10:39Z | - |
| dc.date.available | 2021-08-01 | |
| dc.date.copyright | 2018-08-01 | |
| dc.date.issued | 2018 | |
| dc.date.submitted | 2018-07-18 | |
| dc.identifier.citation | Berry, R. J., Z. Li, J. D. Erickson, S. Li, C. A. Moore, H. Wang, J. Mulinare, P. Zhao, L. Y. Wong, J. Gindler, S. X. Hong and A. Correa (1999). 'Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention.' N Engl J Med 341(20): 1485-1490.
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/69210 | - |
| dc.description.abstract | 背景
血清中補血質 (鐵、葉酸、維他命B12) 和同半胱胺酸的濃度與口腔黏膜疾病和各種全身性疾病及癌症均有相關，但文獻中缺乏對於口腔鱗狀細胞癌的研究，因此，本研究的目的為探討血清中補血質及同半胱胺酸的濃度是否能作為口腔鱗狀細胞癌病人預後之預測因子。 材料與方法 本研究預計自100 位口腔鱗狀細胞癌病人取得術前、術後三個月及術後六個月的血清標本，以及30 位健康對照組取得術前血清標本，口腔鱗狀細胞癌病人會依術前血清中補血質之缺乏有無以及是否給予補血質補充分為三組，所有的血液標本均送至台大醫院檢驗醫學部分析，並以Student’s t-test或paired t-test分析各組間之血清中補血質及同半胱胺酸濃度的差異，並利用Kaplan-Meier method分析血清中補血質及同半胱胺酸濃度與存活率之關係。再利用Log-rank test 進一步推論血清中補血質及同半胱胺酸濃度是否與口腔鱗狀細胞癌患者的存活時間有統計上相關性。 結果 口腔鱗狀細胞癌患者血清中之補血質濃度明顯比非癌症健康受試者病人來得低，而血清中之同半胱胺酸濃度則較高。血清中補血質與同半胱胺酸濃度在腫瘤大小與侵犯深度以及淋巴結轉移的有無上均無差異。喝酒、嚼檳榔、吸菸等口腔習慣會造成血中葉酸濃度降低。給予補血質補充 (主要是葉酸與維他命B12) 可以有效降低血中同半胱胺之濃度，但對於累積存活率以及無疾病累積存活率無明顯的差異。血中葉酸濃度較高與同半胱胺酸濃度較低之口腔鱗狀細胞癌患者之整體存活率，分別比血中葉酸濃度較低與同半胱胺酸濃度較高之口腔鱗狀細胞癌患者明顯為佳；同時血中同半胱胺酸濃度較低之口腔鱗狀細胞癌患者之無疾病存活率，比血中同半胱胺酸濃度較高之口腔鱗狀細胞癌患者明顯為佳。 結論 血中葉酸濃度與同半胱胺酸濃度可視為口腔鱗狀細胞癌的預後預測因子，在口腔鱗狀細胞癌病人中，若血中葉酸濃度小於等於6 ng/mL 或血中同半胱胺酸濃度大於7.0 μmol/L，給予補充葉酸以及維他命B12，以增加血中葉酸濃度及降低血中同半胱胺酸濃度，應可改善口腔鱗狀細胞癌患者的預後。 | zh_TW |
| dc.description.abstract | Background
Serum hematinics (iron, folic acid, and vitamin B12) and homocysteine levels are associated with several oral mucosal diseases, systemic diseases, and different kinds of cancers. There is no study regarding their association with oral cancer in the literature. This study was aimed to investigate whether serum hematinics and homocysteine levels can be factors for prediction of oral squamous cell carcinoma (OSCC) patients’ prognosis. Materials and Methods Serum samples were collected from 100 patients with OSCC before and 3 and 6 months after surgery and from 30 healthy control subjects. All OSCC patients were classified into three groups according to the serum hematinic levels: group I patients had serum hematinic levels within normal limits, group II patients had deficiencies of serum hematinics without supplementation of deficient hematinics, and group III patients had deficiencies of serum hematinics with supplementation of deficient hematinics. All serum samples were sent to Department of Laboratory Medicine, National Taiwan University Hospital for measurement of serum hematinic levels. The mean pre- and post-surgery serum hematinic levels of all OSCC patients and mean serum hematinic levels of normal control subjects were compared by Student’s t-test or paired t-test between any two groups, where appropriate. The correlation between the serum hematinic levels and clinicopathological parameters of OSCC patients was analyzed by Student’s t-test. Cumulative survival was analyzed with the Kaplan-Meier product-limit method. Results OSCC patients had significantly lower mean serum hematinic levels and significantly higher mean serum homocysteine level than healthy control subjects. The serum hematinic and homocysteine levels were not significantly different between OSCC patients with different tumor sizes and different nodal metastases. Alcohol consumption, betel quid chewing, and cigarette smoking were associated with lower mean folic acid level in OSCC patients. Hematinic supplementation (mainly folic acid and vitamin B12) could effectively reduce the homocysteine level in OSCC patients but there was no significant difference in the overall survival and disease-free survival between OSCC patients with or without hematinic supplementation. OSCC patients with higher serum folic acid levels and lower serum homocysteine levels had a significantly better overall survival than those with lower serum folic acid levels and higher serum homocysteine levels, respectively. In addition, OSCC patients with lower serum homocysteine levels had a significantly better disease-free survival than those with higher serum homocysteine levels. Conclusions Serum folic acid level and homocysteine level can be factors for prediction of OSCC patients’ prognosis. Folic acid and vitamin B12 supplementations for OSCC patients whose serum folic acid level is less than or equal to 6 ng/mL or the homocysteine level is higher than 7.0 µmol/L can benefit to the prognosis of OSCC patients. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-17T03:10:39Z (GMT). No. of bitstreams: 1 ntu-107-R03422014-1.pdf: 2357336 bytes, checksum: 458790c5526691c785722c257bdd8d79 (MD5) Previous issue date: 2018 | en |
| dc.description.tableofcontents | 中文摘要 V
英文摘要 VII 第一章 序論及文獻回顧 1 1.1 口腔鱗狀細胞癌概論 1 1.1.1 口腔鱗狀細胞癌簡介 1 1.1.2 口腔鱗狀細胞癌之流行病學 2 1.1.3 口腔鱗狀細胞癌之危險因子 2 1.1.4 口腔鱗狀細胞癌之臨床分期 3 1.1.5 口腔鱗狀細胞癌之治療及預後 4 1.2 同半胱胺酸概論 5 1.2.1 同半胱胺酸簡介 5 1.2.2 高同半胱胺酸血症簡介 6 1.2.3 高同半胱胺酸血症相關疾病 6 1.2.4 補血質及同半胱胺酸與口腔黏膜疾病之關係 9 1.2.5 補血質及同半胱胺酸與癌症之關係 9 第二章 實驗方法 11 2.1 病人資料收集 11 2.2 病人資料分組 11 2.3 試驗資料分析 12 2.4 統計分析 12 第三章 結果 14 3.1 血清中補血質及同半胱胺酸濃度在口腔鱗狀細胞癌患者與非癌症健康受試者間之差異 14 3.2 口腔鱗狀細胞癌患者之血清中補血質及同半胱胺酸濃度與患者臨床及組織病理各項參數之關係 14 3.3 血清中補血質及同半胱胺酸濃度在口腔鱗狀細胞癌患者中不同試驗組別間之差異 17 3.4 給予不同補血質補充後，口腔鱗狀細胞癌患者之血清中補血質及同半胱胺酸濃度之改變 18 3.5 口腔鱗狀細胞癌患者之血清中補血質及同半胱胺酸濃度與存活時間分析 (survival analysis) 20 第四章 討論 22 第五章 結論 26 第六章 附表與附圖 27 參考文獻 50 | |
| dc.language.iso | zh-TW | |
| dc.subject | 預後 | zh_TW |
| dc.subject | 同半胱胺酸 | zh_TW |
| dc.subject | 維他命B12 | zh_TW |
| dc.subject | 葉酸 | zh_TW |
| dc.subject | 補血質 | zh_TW |
| dc.subject | 口腔鱗狀細胞癌 | zh_TW |
| dc.subject | oral squamous cell carcinoma | en |
| dc.subject | serum hematinics | en |
| dc.subject | folic acid | en |
| dc.subject | vitamin B12 | en |
| dc.subject | homocysteine | en |
| dc.subject | prognosis | en |
| dc.title | 以血清中補血質及同半胱胺酸濃度作為口腔鱗狀細胞癌病人預後之預測因子 | zh_TW |
| dc.title | Serum Hematinics and Homocysteine Levels as Factors for Prediction of OSCC Patients’ Prognosis | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 106-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 江俊斌(Chun-Pin Chiang),張龍昌(Long-Chang Chang) | |
| dc.subject.keyword | 口腔鱗狀細胞癌,補血質,葉酸,維他命B12,同半胱胺酸,預後, | zh_TW |
| dc.subject.keyword | oral squamous cell carcinoma,serum hematinics,folic acid,vitamin B12,homocysteine,prognosis, | en |
| dc.relation.page | 55 | |
| dc.identifier.doi | 10.6342/NTU201801568 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2018-07-18 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 臨床牙醫學研究所 | zh_TW |
| 顯示於系所單位： | 臨床牙醫學研究所 | |
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