内镜超声结合E-钙粘素和CD44v6检查在食管癌诊断中的价值

目的　探讨术前内镜超声检查 (EUS)及E -钙粘素 (E -CD)、CD4 4v6表达在食管癌术前分期诊断中的价值。方法　对 5 8例食管鳞癌患者术后标本应用SP法检测E -CD和CD4 4v6的表达 ,对其中 30例食管鳞癌患者术前进行了EUS。结果　EUS诊断食管鳞癌术前TNM分期与术后病理分期对照 ,其T期总的准确率为 83% ,N期总的准确率为 77%。E -CD、CD4 4v6阳性表达率与食管鳞癌患者肿瘤细胞浸润深度、淋巴结转移显著有关 (P <0 .0 1) ,与食管癌患者临床分期有关 (P <13.0 5 )。但在食管鳞癌原发灶中E -CD和CD4 4v6表达无相关性 (P >0 .0 5 )。食管癌患者中UESTN分期与E -CD、CD4 4v6阳性表达率显著相关 (P<0 .0 1)。结论　E -CD和CD4 4v6均可反映食管癌生物学行为的指标 ,将两种细胞粘附分子的检测与EUS结合起来 ,能更准确地对食管癌患者进行TNM分期。

Diagnosis of esophageal cancer:roles of endoscopic ultrasonography and assays of E-cadherin and CD44v6

Objective:The roles of endoscopic ultrasonography (EUS)and assays of E-cadherin(E-CD)and CD44v6 in diagnosing esophageal cancer was evaluated. Methods:SP immunohistochemical technique was used to detect the expression of E- cadherin and CD44v6 in 58 operative specimen of esophageal squamous carcinoma. EUS was performed on 30 patients. Results: With EUS the diagnostic total accuracy of T staging was 83% and the overall accuracy of N staging was 77%,while the percentage of accuracy of staging with preoperative TNM standards compared with postoperative clinical pathology staging. There's close relationship between positive expression rate of E-cadherin expression and invasion depth,lymph node metastasis in esophageal squamous cell carcinoma patients( P <0.01),Significant correlation was found between clinical stage and E-cadherin expression in the patients( P <0.05);Positive expression rate of CD44v6 closely correlate with invasion depth,lymph node metastasis in esophageal squamous cell carcinoma patients( P <0.01),CD44v6 expression also significantly correlate with clinical stage( P <0.05). In addition,E-cadherin expression have no correlation with CD44v6 expression in esophageal squamous cell carcinoma petients( P >0.05). There is close relationship between TN staging of EUS with positive expression rate of E-cadherin and CD44v6 in esophageal squamous cell carcinoma patients( P <0.01).Conclusions: Since E-CD and CD44v6 are the criteria capable of standing for the bio-behavior of esophageal cancer,combination of these assessment with EUS is helpful in TNM staging of esophageal cancer.