内镜超声、表皮生长因子受体、转化生长因子β_1受体检查在大肠癌诊断中的价值

Diagnosis of colorectal cancer: roles of endoscopic ultrasonography and assays of epidermal growth factor receptor & transforming growth factor-beta type Ⅰ receptor

目的研究术前内镜超声检查(EUS)及表皮生长因子受体(EGFR)、转化生长因子 β1 受体(TGF βR1)表达在大肠癌术前分期诊断中的价值。方法对35例大肠癌患者进行了EUS ,并对其活检组织用免疫组化法检测了EGFR、TGF βR1 的表达。结果EUS诊断大肠癌有无淋巴结转移准确率为77 % ,术前TNM分期与术后病理Dukes分期对照 ,准确率为74 %。35例中EGFR表达阳性17例 ,有淋巴结转移者阳性率明显高于无淋巴结转移者 ,分别为80 % ,25 %(P<0.01)。TGF βR1 的阳性表达为54 % ,并与大肠癌淋巴结转移存在负相关性(P<0.05) ,与大肠癌Dukes分期存在负相关性(P<0.05)。与术后病理对照 ,EUS及EGFR、TGF βR1 在大肠癌淋巴结转移方面的判断是一致的。结论EGFR、TGF βR1 均是可反映大肠癌生 物学行为的指标。将两种受体的检测与EUS结合起来 。

Objective The roles of endoscopic ultrasonography (EUS) and assays of epidermal growth factor receptor (EGFR) and transforming growth factor beta type Ⅰ receptor (TGF-βR1) in diagnosing colorectal cancer was evaluated.Methods EUS was exercised on 35 patients with colorectal cancer. The biopsied tissues were assessed for expressions of EGFR and TGF-βR1 with immunohistochemistry.Results With EUS the diagnostic accuracy for lymphatic metastasis fell in 77 percent, while the percentage of accuracy of staging with preoperative TNM standards as compared with postoperative Dukes’ was 74. EGFR expressed positively in 17/35 cases with a higher positivity in those who had lymphatic metastasis than those had not (being 80% and 25% respectively, P< 0.01).Whereas TGF-βR1 positive expression was found in 54 percent of individuals with a negative correlation (P< 0.05) in terms of lymphatic metastasis and Dukes’ staging (P< 0.05). With regard to predicting colorectal lymphatic metastasis the findings of EUS, EGFR and TGF-βR1 were in accordance with that of pathology. Conclusion Since EGFR and TGF-βR1 are the criteria capable of standing for the bio-behaviour of colorectal cancer, combination of these assessments with EUS may be a supplement to the imperfect TNM staging.