食管癌术后吻合口狭窄组织TGF-β1和CTGF的表达

Expressions of TGF-β1 and CTGF in postoperative anastomotic stenosis tissues after esophageal cancer resection

目的探讨食管癌术后吻合口狭窄组织中转化生长因子β1(TGF-β1)和结缔组织生长因子(CTGF)的表达。方法因食管癌术后出现吞咽困难患者37例分为3组:轻度狭窄组(19例),Stooler 1、2级;中度狭窄组(12例),Stooler 3级;重度狭窄组(6例),Stooler 4级。对照组20例,食管癌术后无吞咽困难。经纤维内镜在吻合口狭窄区不同部位钳夹米粒大小组织3-4块,免疫组化观察TGF-β1和CTGF的表达。结果对照组TGF-β1和CTGF表达弱阳性。吻合口狭窄患者TGF-β1和CTGF持续阳性表达,且随着狭窄严重程度增加而表达增加(P<0.01)。结论在创伤修复或纤维化过程中,TGF-β1和CTGF通路在良性吻合口狭窄的形成过程中被激活,并在导致瘢痕形成中发挥了重要的作用。

Objective To investigate the expressions of transforming growth factor-β1 （TGF） and connective tissue growth factor （CTGF） in postoperative anastomotic stenosis tissues after esophageal cancer resection. Methods A total of 37 patients with dysphagia after surgery for esophagus cancer was divided into three groups of A（19 cases with mild anastomotic stenosis, Stooler grade 1 or 2）, B（12 cases with moderate anastomotic stenosis, Stooler grade 3） and C（6 cases with severe anastomotic stenosis, Stooler grade 4）. Another 20 cases without anastomotic stenosis were taken as the controls. Three or four rice-sized pieces of anastomotic tissues were taken out for detecting the expressions of TGF-β1 and CTGF by immunohistochemistry. Results The expressions of TGF-β1 and CTGF in eontrol group were weakly positive, which were consistently positive and increased as the increase in the severity of stenosis（P〈0. 01）. Conclusion The pathways of TGF-β1 and CTGF are activated during the process of wound repair, which play an important role in the course of anastomotic stenosis formation.