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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 ,对目前尚不理想的术前TNM分期是一个有益的补充
Objective To investigate the value of preoperative endoscopic ultrasonography (EUS) and the expression of epidermal growth factor receptor (EGFR) and transforming growth factor-β1 receptor (TGFβR1) in preoperative staging of colorectal cancer. METHODS: EUS was performed on 35 patients with colorectal cancer. Immunohistochemistry was used to detect the expression of EGFR and TGFβR1 in the biopsies. Results The accuracy of EUS in the diagnosis of colorectal cancer with or without lymph node metastasis was 77%. The preoperative TNM staging and postoperative pathological Dukes stage contrast were 74% accurate. Of the 35 patients, 17 were positive for EGFR expression, and those with lymph node metastasis were significantly higher than those without lymph node metastasis (80% and 25%, respectively) (P<0.01). The positive expression of TGFβR1 was 54%, which was negatively correlated with the lymph node metastasis of colorectal cancer (P<0.05), and negatively correlated with Dukes stage of colorectal cancer (P<0.05). Compared with postoperative pathology, EUS and EGFR and TGFβR1 were consistent in the judgment of lymph node metastasis of colorectal cancer. Conclusions Both EGFR and TGF βR1 are indicators that can reflect the biological behavior of colorectal cancer. Combining the detection of two receptors with EUS is a useful supplement to the currently unsatisfactory preoperative TNM staging.