目的：检测贲门腺癌（ gastric cardiac adenocarcinoma, GCA）中抑癌基因脾酪氨酸激酶（spleen tyrosine kinase, Syk）及原癌基因c-erbB-2、表皮生长因子受体（epidermal growth factor receptor, EGFR）的表达情况，探讨其相互关系及其与贲门腺癌发生、发展的关系。方法：收集河北医科大学第四医院胸外科2006年10月至2007年2月手术切除贲门腺癌标本91例，患者术前未经任何抗癌治疗。应用免疫组化SP法检测贲门腺癌组织及相应切缘外正常黏膜组织中Syk、c-erbB-2、EGFR的表达情况，进行相关性比较。结果：Syk在贲门腺癌组织的阳性表达率为24.18%，明显低于相应切缘外正常组织（60.44%，P<001)。c-erbB-2、EGFR在贲门腺癌组织的阳性表达率分别为56.04%和58.24%，明显高于其在相应切缘外正常组织中的阳性表达率（20.88%，21.98%；均P<0.01）。Syk及c-erbB-2表达均与肿瘤组织的病理分级、淋巴结转移及TNM分期有明显的相关性（P<0.05或P<0.01)。EGFR表达仅与淋巴结转移相关(P<0.01)。Syk与c-erbB-2和EGFR表达均有相关性(P<0.05)，而Syk和EGFR表达两者无明显相关性(P>0.05)。结论: Syk、c-erbB-2、EGFR基因在贲门腺癌中均异常表达，可能与贲门腺癌的发生有关；3种蛋白的联合检测对贲门腺癌的预后评估有一定的指导意义。

Objective: To investigate the expressions of Syk (spleen tyrosine kinase), c-erbB-2 and epidermal growth factor receptor (EGFR) in gastric cardiac adenocarcinoma (GCA) and corresponding adjacent normal tissues, and to discuss their relationship with development and progression of GCA. Methods: Ninety-one GCA samples were obtained from the Fourth Hospital of Hebei Medical University (from Oct. 2006 to Dec. 2007). The expressions of Syk, c-erbB-2 and EGFR in GCA and corresponding adjacent normal tissues were determined by immunohistochemistry, and their correlations were analyzed. Results: The positive expression rate of Syk in GCA tissues was 24.18%, which was significantly lower than that in the adjacent normal tissues (60.44%, P<0.01). And the positive expression rates of c-erbB-2 and EGFR in GCA tissues were 56.04% and 58.24%, respectively, which were also higher than those in the adjacent normal tissues (P<0.01). The expressions of Syk and c-erbB-2 were correlated with pathology grade, lymphatic metastasis and TNM stage of GCA, and EGFR expression was only correlated with lymphatic metastasis. The expression of Syk was correlated with those of c-erbB-2 and EGFR (P<0.05), but Syk expression had no correlation with EGFR expression (P>0.05). Conclusion: Syk, c-erbB-2 and EGFR are abnormally expressed in GCA, which may contribute to pathogenesis of GCA. The combined detection of Syk, c-erbB-2 and EGFR may have potential significance in prognosis prediction of GCA.

河北省科学技术研究与发展计划项目（No.072761223）