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目的探讨食管癌术后吻合口狭窄组织中转化生长因子β1(TGF-β1)和结缔组织生长因子(CTGF)的表达。方法因食管癌术后出现吞咽困难患者37例分为3组:轻度狭窄组(19例),Stooler 1、2级;中度狭窄组(12例),Stooler 3级;重度狭窄组(6例),Stooler 4级。对照组20例,食管癌术后无吞咽困难。经纤维内镜在吻合口狭窄区不同部位钳夹米粒大小组织3-4块,免疫组化观察TGF-β1和CTGF的表达。结果对照组TGF-β1和CTGF表达弱阳性。吻合口狭窄患者TGF-β1和CTGF持续阳性表达,且随着狭窄严重程度增加而表达增加(P<0.01)。结论在创伤修复或纤维化过程中,TGF-β1和CTGF通路在良性吻合口狭窄的形成过程中被激活,并在导致瘢痕形成中发挥了重要的作用。
Objective To investigate the expression of transforming growth factor β1 (TGF-β1) and connective tissue growth factor (CTGF) in the anastomotic strictures of esophageal cancer patients. Methods Thirty-seven patients with dysphagia after esophageal cancer surgery were divided into three groups: mild stenosis group (19 cases), Stooler grade 1, 2 moderate stenosis group (12 cases), Stooler grade 3 severe stenosis group Example), Stooler level 4. Control group of 20 patients without esophageal dysphagia after swallowing. Fibrous endometrial tissues were dissected for 3-4 blocks in different parts of the anastomotic stenosis area. The expressions of TGF-β1 and CTGF were observed by immunohistochemistry. Results The expression of TGF-β1 and CTGF in the control group was weakly positive. The expression of TGF-β1 and CTGF in patients with anastomotic stricture was continuously increased and increased with the severity of stenosis (P <0.01). Conclusion TGF-β1 and CTGF pathways are activated during the process of wound repair or fibrosis during the formation of benign anastomotic stenosis and play an important role in causing scarring.