The Diagnostic Value Investigation Of Endoscopic Ultrasonography And The Expression Of Cdk1,survivin In The Preoperative Tn Staging Of Esophageal Carcinoma

Objective:To probe the diagnostic value of Endoscopic Ultrasonography (EUS) in the preoperative TN staging of esophageal carcinoma; to probe the expression of CDK1,survivin protein in different tissue type,differentiation of esophageal carcinoma and the diagnostic value in the preoperative TN staging of esophageal carcinoma.Methods:Select 30 esophageal carcinoma patients who are probable to undergo radical surgery in our hospital, let them have EUS examination and TN staging; Compare EUS staging with that of surgical pathologic. we examine the expression of CDK1,survivin protein in 30 esophageal cancer cases and 10 normal esophageal epithelium cases by immunohistochemical method, analyse the expression of CDK1,survivin protein in normal esophageal tissues, esophageal cancer of different histological type,differentiation and TN staging. Results:The accuracy in T,N staging of endoscopic ultrasonography are 76.7%(23/30),83.3%(25/30)respectively; The rate of the preoperative T staging of EUS in early esophageal carcinoma is up to 100% with surgical pathologic staging.CDK1,survivin protein express most in the cytoplasm, few express in nucleus or both in cytoplasm and nucleus. In 30 esophageal carcinoma cases, CDK1 express in 20 cases, the positive rate is 66.7%, and survivin express in 25 cases, the positive rate is 83.3%; there is only one case with CDK1,survivin expressed in the 10 normal esophageal epithelium cases respectively, the positive rate is 10%. The expression of CDK1,survivin are significantly different in benign and malignant esophageal lesions (P <0.01); It has significant statistical difference in the positive correlation between the expression of CDK1 and that in survivin (P <0.01); there are 27 cases if that either is expressed is positive expression and the positive rate is up to 90%. It is no significant difference of CDK1,survivin expression between various pathological types, different grade squamous cell esophageal cancer and different TN staging respectively(P> 0.05). There are 6 cases CDk1 positively expressed and 9 cases survivin in 14 cases without lymph node metastasis; and there are 14 cases CDk1 positively expressed and 16 cases surviving in 16 cases with lymph node metastasis. The expression of CDK1, survivin is significantly different in different N staging (P <0.05).Conclusions:The accuracy of EUS in esophageal carcinoma preoperative TN staging is relatively high, especially in the preoperative staging of early esophageal carcinoma, the accuracy rate can up to 100%; the expression of CDK1, survivin in cancers is obviously higher than the expression in normal tissues, which can increase the detection rate of esophageal cancer. The expression of and survivin increases with the progress of different T stages; the expression of CDK1 and survivin is positively correlated with lymph node metastasis. Combining with the TN staging of EUS, they play an important role in the timing of clinical treatment strategies, the surgical options and give some guidance in the determination of long-term prognosis.