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目的:检测贲门腺癌(gastric cardiac adenocarcinoma,GCA)中抑癌基因脾酪氨酸激酶(spleen tyrosine kinase,Syk)及原癌基因c-erbB-2、表皮生长因子受体(epidermal growth factor receptor,EGFR)的表达情况,探讨其相互关系及其与贲门腺癌发生、发展的关系。方法:收集河北医科大学第四医院胸外科2006年10月至2007年2月手术切除贲门腺癌标本91例,患者术前未经任何抗癌治疗。应用免疫组化SP法检测贲门腺癌组织及相应切缘外正常黏膜组织中Syk、c-erbB-2、EGFR的表达情况,进行相关性比较。结果:Syk在贲门腺癌组织的阳性表达率为24.18%,明显低于相应切缘外正常组织(60.44%,P<0.01)。c-erbB-2、EGFR在贲门腺癌组织的阳性表达率分别为56.04%和58.24%,明显高于其在相应切缘外正常组织中的阳性表达率(20.88%,21.98%;均P<0.01)。Syk及c-erbB-2表达均与肿瘤组织的病理分级、淋巴结转移及TNM分期有明显的相关性(P<0.05或P<0.01)。EGFR表达仅与淋巴结转移相关(P<0.01)。Syk与c-erbB-2和EGFR表达均有相关性(P<0.05),而Syk和EGFR表达两者无明显相关性(P>0.05)。结论:Syk、c-erbB-2、EGFR基因在贲门腺癌中均异常表达,可能与贲门腺癌的发生有关;3种蛋白的联合检测对贲门腺癌的预后评估有一定的指导意义。
Objective: To detect the expression of spleen tyrosine kinase (Syk), c-erbB-2 and epidermal growth factor receptor (VEGF) in gastric cardiac adenocarcinoma (GCA) EGFR) expression, to explore the relationship between them and the occurrence and development of gastric cardia adenocarcinoma. Methods: Totally 91 cases of gastric cardia adenocarcinoma were collected from the Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University from October 2006 to February 2007 without any anti-cancer therapy before operation. The expression of Syk, c-erbB-2 and EGFR in gastric cardia adenocarcinoma tissues and corresponding normal mucosa tissues was detected by immunohistochemical SP method and the correlation was compared. Results: The positive expression rate of Syk in gastric cardia adenocarcinoma was 24.18%, which was significantly lower than that in the corresponding normal tissues (60.44%, P <0.01). The positive rates of c-erbB-2 and EGFR in gastric cardia adenocarcinoma were 56.04% and 58.24%, respectively, which were significantly higher than those in normal tissues (20.88%, 21.98%, P < 0.01). The expressions of Syk and c-erbB-2 were significantly correlated with the histological grade, lymph node metastasis and TNM stage (P <0.05 or P <0.01). EGFR expression was only associated with lymph node metastasis (P <0.01). There was a significant correlation between Syk and c-erbB-2 and EGFR (P <0.05), but there was no significant correlation between Syk and EGFR (P> 0.05). Conclusion: Syk, c-erbB-2 and EGFR genes are all abnormally expressed in gastric cardia adenocarcinoma, which may be related to the occurrence of gastric cardia adenocarcinoma. The combined detection of these three proteins may be helpful for the prognosis evaluation of gastric cardia adenocarcinoma.