Tan Shi-Yun, Wang Jun-Yu, Shen Lei, Luo He-Sheng, Shen Zhi-Xiang
Department of Gastro-enterology, Renmin Hospital, Wuhan University, Wuhan 430060, Hubei Province, China.
World J Gastroenterol. 2007 Apr 14;13(14):2108-12. doi: 10.3748/wjg.v13.i14.2108.
To investigate the relationship between the staging by endoscopic ultrasonography (EUS) and the expression of carcinoma metastasis associated gene in the patients with gastric carcinoma.
Sixty-three patients with gastric cancer were diagnosed by electric gastroscopy and EUS. The preoperative staging of gastric cancer was measured by EUS and compared with pathologic staging and MMP-9 expression. Peripheral serum level of MMP-9 was measured with enzyme-linked immunosorbent assay (ELISA), while the expression of MMP-9 protein was tested with immunohistochemistry and hybridization in situ in the gastric carcinoma tissues.
The total accuracy of EUS in estimating invasive depth of gastric cancer was 80.95%, while that in estimating lymphatic metastasis was 73.02%. Serum MMP-9 levels were consistent with the expression of MMP-9 protein and MMP-9 mRNA in tissue, a result closely correlated with invasive degree, staging with EUS and lymphatic metastasis in gastric cancer (P<0.05). The total accuracy of estimating invasive depth in gastric cancer was 95.22% using both EUS and MMP-9.
The MMP-9 level of preoperative serum presents the reference value for preoperative staging by EUS in the patients with gastric cancer. When serum MMP-9 level in gastric cancer is significantly high, physicians should pay closer attention to the metastasis which reaches the serosa or beyond. Combining EUS and MMP-9 improves the accuracy in deciding the invasion and metastasis in the patients with gastric carcinoma.
探讨超声内镜(EUS)分期与胃癌患者癌转移相关基因表达之间的关系。
63例胃癌患者经电子胃镜及EUS诊断。通过EUS测量胃癌术前分期,并与病理分期及基质金属蛋白酶-9(MMP-9)表达进行比较。采用酶联免疫吸附测定(ELISA)检测外周血MMP-9水平,同时应用免疫组织化学及原位杂交法检测胃癌组织中MMP-9蛋白的表达。
EUS评估胃癌浸润深度的总准确率为80.95%,评估淋巴结转移的总准确率为73.02%。血清MMP-9水平与组织中MMP-9蛋白及MMP-9 mRNA的表达一致,其结果与胃癌的浸润程度、EUS分期及淋巴结转移密切相关(P<0.05)。联合应用EUS及MMP-9评估胃癌浸润深度的总准确率为95.22%。
术前血清MMP-9水平可为胃癌患者EUS术前分期提供参考依据。当胃癌患者血清MMP-9水平显著升高时,医生应密切关注肿瘤是否侵犯至浆膜层或浆膜外。联合应用EUS及MMP-9可提高判断胃癌患者侵袭及转移情况的准确性。