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研究生: 劉彥廷
Yen-Ting Liu
論文名稱: 循環訊號量測系統應用於乳癌患者之初步研究
Preliminary study of applying the hemodynamic signal analysis in the breast cancer subjects
指導教授: 許昕
Hsin Hsiu
口試委員: 鮑建國
Jian-Guo Bau
高震宇
Chen-Yu Kao
許家良
none
學位類別: 碩士
Master
系所名稱: 應用科技學院 - 醫學工程研究所
Graduate Institute of Biomedical Engineering
論文出版年: 2015
畢業學年度: 103
語文別: 中文
論文頁數: 53
中文關鍵詞: 癌症早期偵測循環系統量測乳癌非侵入式量測
外文關鍵詞: Cancer, early detection, measurement circulatory system, breast cancer, non-invasive measurement
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  • 癌症已連續32年為國人死因首位,其比例遠高於排名第二的心血管疾病。隨著人口高齡化、不良生活習慣等因素,癌症早期篩檢成為近期熱門的主題。
    癌症是指異常的細胞不斷自我複製並且向周遭的細胞擴散,且腫瘤細胞的周圍會不斷的新生血管。腫瘤的新生血管其形狀是呈現不規則狀,許多血管特性都是異常的狀態。其狀態即為血液循環系統對人體組織供血出現異常。因此我們期望可以透過非侵入式量測人體循環參數,來達到癌症的早期偵測。
    此研究利用本實驗室研發的血壓脈波量測與分析技術,搭配上雷射都卜勒新開發的分析指標,來針對乳癌患者進行量測並收取數據。同時透過同年齡層的正常女性做為對照組來比較,以了解惡性腫瘤對人體的循環功能有何影響,進一步訂定出惡性腫瘤與人體循環參數之間的模式。
    在實驗設計方面,將正常女性的右側定義為對照組。乳癌患者定義為實驗組。實驗組依照TNM分期系統,將第0期、第1期、第2期定義為B組;第3期、第4期定義為A組。以此種方式分組不僅可以得到癌症患者與正常人的差異,也可以了解隨著癌症病程的發展,對患者造成哪些改變。
    實驗結果的對照比較中,我們採用的許多參數分析指標的變化都具有顯著的解析能力。血壓波型屬於全身性的循環,因此血壓波型可以評估全身性的供血狀態;而雷射都卜勒屬於局部組織供血,對於身體供血狀況的評估可以將範圍縮小。並且若將兩者配合,可以得到更多的供血狀態資訊。
    本實驗現階段的目的是確認我們所開發的量測系統應用於癌症上有解析其疾病的能力。在工程方面,我們有許多指標都可以發現癌症患者與正常人的差異;在醫學方面我們也有針對其指標的差異對其做生理解釋。
    我們曾經針對多囊性卵巢症、中風、糖尿病等疾病,探討其指標參數與正常人的差異,對於疾病與微循環的探討已經有一定的基礎。因此我們希望以此實驗為推動「微循環檢測癌症」的第一步,建立一套可以具有一定準確度且富有便利性的系統。


    Cancer has been top position of domestic top ten cause of death for thirty-two years. The occupied proportion is much more than cardiovascular diseases which is second position. Along with aging of population, unhealthy lifestyle and more, early detection of cancer has become a popular issue.
    Cancer can be attributed to unusual cell replication, and cancer cells had uninterrupted angiogenesis. The vessels of cancer cells are irregular and vessel characteristics are abnormal. This abnormal states will make human circulatory system uncharacteristic. Therefore we expect to early detect cancer by noninvasive measurement of human circulatory parameters.
    This preliminary study used blood-pressure waveform measurement system developed by ourselves and commercial laser doppler flowmetry to measure circulatory parameters of breast cancer patients. In addition, they will be compared to healthy females with matched age to study the patterns between cancer and human circulatory parameters.
    Experimental design defines right side of healthy females as control group. Cancer patients are defined as “A group” or “B group” by TNM staging system. We expect to find the differences between healthy females and cancer patients, as well as we want to know the influences caused by cancer in course of disease.
    According to experimental results, many parameter indicators we used in the study are significant. Blood-pressure waveform is relating with systemic circulation, we can evaluate systemic blood-supply states. Laser Doppler is relating with microcirculation, we can evaluate blood-supply states of local tissues. Combine both parameters can obtain more information of blood-supply states.
    At the present stage, we would like to verify that our measurement system is capable for analysis in cancer. In engineering, we can find many differences of indicators between healthy females and cancer patients, in medicine, we explained differences of indicators in physiology.
    We had some previous studies about PCOS, stroke, diabetes, and other diseases. We got foundation of studying diseases. Consequently, we expect this study to become first step of hemodynamic cancer detection, and construct accurate and convenient detection system.

    第一章緒論............................................................ 1 1.1 研究背景..................................................... 1 1.1.1癌症:乳癌.......................................... 1 1.1.2癌症之早期篩檢...................................... 2 1.1.3循環系統............................................ 3 1.1.4循環系統與惡性腫瘤的關係............................ 3 1.1.5循環參數的意義...................................... 4 1.2 研究動機與目的............................................... 6 第二章實驗設計........................................................ 7 2.1分組比較.................................................... 7 2.2量測架構................................................... 8 2.3實驗條件控制................................................10 第三章實驗儀器與硬體系統..............................................11 3.1 血壓波型......................................................11 3.2 雷射都卜勒血流儀..............................................13 3.3 心電圖放大模組................................................14 3.4 類比數位擷取卡................................................15 3.5 儲存裝置......................................................15 第四章實驗流程........................................................16 4.1實驗步驟....................................................17 4.2實驗注意事項................................................18 4.3探頭放置步驟................................................19 4.3.1血壓波型................................................19 4.3.2雷射都卜勒..............................................20 4.3.3心電圖..................................................21 第五章實驗分析方法與參數..............................................23 5.1 分析方法.....................................................23 5.2 分析方法與參數介紹...........................................24 5.2.1血壓波型時域、諧波分析參數.............................24 5.2.2 LDF時域、血流供應分析參數............................28 第六章實驗結果........................................................30 6.1 受試者基本生理資料表.........................................31 6.2 血壓波型實驗結果.............................................32 6.2.1 BPW時域參數.........................................32 6.2.2 BPW頻域諧波參數.....................................34 6.2.3 BPW頻域諧波相位角參數...............................36 6.3 LDF實驗結果.................................................38 6.3.1 LDF時域參數.........................................38 6.3.2 LDF血流供應參數.....................................40 第七章結果討論........................................................42 7.1 血壓波型參數生理意義.........................................43 7.2 血壓波型實驗結果討論.........................................44 7.3 雷射都卜勒參數生理意義.......................................46 7.4 雷射都卜勒實驗結果討論.......................................47 第八章結論與未來展望..................................................48 8.1 結論.........................................................48 8.2 未來展望.....................................................50 第九章參考文獻........................................................51  

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