不同分期食管癌影像学及肿瘤分子标志物研究

目的探讨不同分期食管癌的影像学及肿瘤分子标志物垂体肿瘤转化基因(PTTG)和基质金属蛋白酶(MMPs)进展。方法选择荆门市第一人民医院胸心外科2012年5月至2013年5月食管癌患者80例作为观察对象,均进行超声内镜(EUS)和CT检查,进行临床TNM分期,并与病理结果进行比较,评价不同检测方法的准确性,同时对癌组织中PTTG和MMP-9的蛋白表达进行检测,结合EUS检查临床分期进行分析,评价临床分期准确性。结果 EUS检查食管癌T分期准确率77.5%(62/80)显著高于CT检查55.0%(44/80),差异有统计学意义(χ2=9.06,P0.05),检查N分期准确率75.0%(60/80)略低于CT检查77.5%(62/80),但差异无统计学意义(χ2=0.14,P0.05);PTTG和MMP-9蛋白阳性表达率分别为68.8%(55/80)和62.5%(50/80);EUS与PTTG、MMP-9单独或联合检查可以提高食管癌T分期、N分期的准确率,但差异无统计学意义(P0.05)。结论 EUS检查对食管癌患者T分期的诊断准确率较高,结合PTTG和MMP-9蛋白表达,提高诊断准确率。

Study of esophageal cancer imaging and molecular tumor markers at the different stages

Objective To explore the progression of esophageal cancer imaging and PTTG and MMPs of molecular tumor markers at different phases. Methods Eighty esophageal cancer cases were selected in Jingmen hospital from May 2012 to May 2013 as the subjects of observation. Endoscopic ultrasonography（EUS） and CT examination, clinical TNM stage were performed, and the results were compared with the pathological ones to evaluate the accuracy of different detection methods. While the PTTG and MMP-9 protein in cancer tissue was detected and the staging system were analyzed in combination with EUS check so as to evaluate accuracy of clinical staging.Results The accuracy of T staging of esophageal cancer by EUS examination（ 77.5%, 62/80） was significantly higher than by CT（55.0%, 44/80）, showing the statistically significant difference（χ^2=9.06,P 0.05）. The accuracy rate of N staging（75%,60/80） was slightly lower than by CT（77.5%,62/80）, but the difference was not significant（χ^2=0.14,P 0.05）. Positive rates of PTTG and MMP-9 expression were 68.8%（55/80） and 62.5%（50/80）, respectively; both individual EUS and MMP-9 alone or EUS in combination with PTTG could improve the accuracy rate of T staging and N staging of esophageal cancer, and no significant difference was found（P〈0.05）.Conclusion EUS examination had higher accuracy in diagnosis of T stage of esophageal cancer, the combined detection of PTTG and MMP-9 protein expression could improve the accuracy of diagnosis.