作者：王自涛，王瑞波，孙江华

单位：邯郸市第一医院 普外科， 河北 邯郸 056000

Authors: Wang Zitao，Wang Ruibo，Sun Jianghua

Unit: Department of General Surgery，the First Hospital of Handan，Handan  056000，Hebei，China

摘要：

目的 探讨人类表皮生长因子受体2 (CerbB-2)、细胞周期检验点激酶1 (CHK1)及RAD51蛋白在食管胃结合部腺癌（AEG）患者中的表达意义。方法 回顾性分析2020年1月至2022年1月在邯郸市第一医院确诊为AEG的180例患者资料，取癌变部位组织标本180份作为癌变组，取其远端正常胃黏膜组织180份作为对照组，选取同时期胃黏膜上皮内瘤变组织152份，并按照瘤变程度分为中低级别上皮内瘤变组（n=69）及高级别上皮内瘤变组（n=83）。采用蛋白质印迹法检测CerbB-2、CHK1、RAD51蛋白在各组中的表达；受试者操作特征曲线（ROC曲线）分析CerbB-2、CHK1、RAD51蛋白联合检测对AEG的诊断价值；分析各蛋白与AEG患者临床病理特征的关系并探讨其相关机制。结果 CerbB-2、CHK1、RAD51蛋白在各组别之间的表达水平差异有统计学意义，且均为对照组<中低级别上皮内瘤变组<高级别上皮内瘤变组<癌变组（均P<0.05）;ROC曲线显示CerbB-2、CHK1、RAD51蛋白联合检测的曲线下面积高于单一检测，敏感度为90.30%，特异度为85.60%;CerbB-2、CHK1、RAD51蛋白阳性表达均与分化程度、Lauren分型相关，但RAD51蛋白阳性表达还与淋巴结转移相关（均P<0.05）;CerbB-2、CHK1、RAD51蛋白阳性表达率均与分化程度、Lauren分型呈负相关，其中RAD51与淋巴结转移呈正相关（均P<0.05）。结论 CerbB-2、CHK1、RAD51蛋白均在AEG患者中呈现高表达，且与疾病进程及病理特征相关，可通过检测其表达水平或阳性率诊断疾病发生及进展情况。

关键词：人类表皮生长因子受体2； 细胞周期检验点激酶1； RAD51蛋白； 食管胃结合部癌

Abstract：

Objective To investigate the expression of human epidermal growth factor receptor 2(CerbB -2)，cell cycle test point kinase 1 (CHK1) and RAD51 proteins in patients with esophagogastric junction adenocarcinoma (AEG). Method Retrospective analysis was performed on the data of 180 patients diagnosed with AEG in The First Hospital of Handan from January 2020 to January 2022. 180 tissue samples of cancerous sites were extracted as the cancer group，and 180 tissues of distal normal gastric mucosa were extracted as the control group. 152 intraepithelial neoplasia tissues of gastric mucosa in the same period were selected and divided into medium and low grade intraepithelial neoplasia group (n =69) and high grade intraepithelial neoplasia group(n=83). Western blotting was used to detect the expression of CerbB-2 ，CHK1 and RAD51 proteins in each group. Receiver operating characteristic (ROC) curve analysis of the diagnostic value of combined detection of CerbB-2，CHK1 and RAD51 proteins for AEG. The relationship between each protein and the clinicopathological characteristics of AEG patients was analyzed and the related mechanism was further discussed. Result There were significant differences in CerbB-2，CHK1 and RAD51 proteins in all groups：control group ＜medium and low grade intraepithelial neoplasia group ＜high grade intraepithelial neoplasia group＜cancer group (all P＜0.05); ROC curve showed that the area under the curve of the combined detection of CerbB-2，CHK1 and RAD51 proteins was significantly higher than that of the single detection ，with a sensitivity of 90.30% and specificity of 85.60%. The positive expression of CerbB-2，CHK1 and RAD51 proteins were closely correlated with the degree of differentiation and Lauren typing，but the positive expression of RAD51 protein was also closely correlated with lymph node metastasis (all P＜0.05). The positive expression rates of CerbB-2，CHK1 and RAD51 proteins were negatively correlated with the degree of differentiation and Lauren typing，and RAD51 was positively correlated with lymph node metastasis (all P＜0.05). Conclusion CerbB-2，CHK1 and RAD51 proteins are highly expressed in Patients with AEG，and are closely related to disease progression and pathological features. The occurrence and progression of AEG can be diagnosed by detecting their expression level or positive rate.

Key Words:  Human epidermal growth factor receptor 2;  Cell cycle test point kinase 1;  RAD51 protein;  Esophagogastric junction carcinoma