{"title":"胃癌组织芯片中 Met 和 YAP 的表达及其临床意义","authors":"Jinxia Li, Xinyun Zhang, Ying Liu, Jinyong Zhou, Li Shen, Guangxin Yue","doi":"10.1155/2024/5591298","DOIUrl":null,"url":null,"abstract":"<i>Objective</i>. This study is aimed at investigating the expression of Met and YAP in gastric cancer and their impact on clinical prognosis. <i>Methods</i>. Tissue samples and clinical data were collected from 89 patients with gastric cancer. Immunohistochemistry was performed to quantify the expression of Met and YAP using tissue microarray. The correlation between the expressions of Met, YAP, and clinicopathological characteristics of patients was determined using a chi-square test. Survival analysis was conducted using the Kaplan-Meier method, while multivariate survival analysis was performed using the Cox proportional hazard model. Bioinformatics analysis was carried out by downloading chip data from TCGA. <i>Results</i>. The expression levels of both Met and YAP were significantly higher in gastric cancer tissues compared to adjacent tissues (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"></path></g></svg>).</span></span> Met expression showed a positive association with P53 and CD133, whereas YAP expression correlated positively with tumor grade and CD133 (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"></path></g></svg>).</span></span> Pearson’s analysis revealed a significant correlation between Met expression and VEGFR as well as CD133, while YAP expression correlated with Ki67 and VEGFR (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-54\"></use></g></svg>).</span></span> Patients with high levels of both Met and YAP exhibited decreased survival time (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-50\"></use></g></svg>).</span></span> Furthermore, Met expression, N stage, and VEGFR were identified as independent risk factors for gastric cancer prognosis (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 9.2729\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-54\"></use></g></svg>),</span></span> whereas no such association was observed for YAP expression. Bioinformatics analysis demonstrated a significant correlation between the expressions of Met and YAP; both proteins were highly expressed in gastric cancer patients accompanied by markedly reduced survival time. <i>Conclusion</i>. The expressions of Met and YAP are closely associated with the survival outcomes as well as clinicopathological features in patients with gastric cancer. Moreover, our findings highlight that Met serves as an independent prognostic factor for gastric cancer.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":"44 1","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Expressions and Clinical Significance of Met and YAP in Gastric Cancer Tissue Microarray\",\"authors\":\"Jinxia Li, Xinyun Zhang, Ying Liu, Jinyong Zhou, Li Shen, Guangxin Yue\",\"doi\":\"10.1155/2024/5591298\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<i>Objective</i>. This study is aimed at investigating the expression of Met and YAP in gastric cancer and their impact on clinical prognosis. <i>Methods</i>. Tissue samples and clinical data were collected from 89 patients with gastric cancer. Immunohistochemistry was performed to quantify the expression of Met and YAP using tissue microarray. The correlation between the expressions of Met, YAP, and clinicopathological characteristics of patients was determined using a chi-square test. Survival analysis was conducted using the Kaplan-Meier method, while multivariate survival analysis was performed using the Cox proportional hazard model. Bioinformatics analysis was carried out by downloading chip data from TCGA. <i>Results</i>. The expression levels of both Met and YAP were significantly higher in gastric cancer tissues compared to adjacent tissues (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"></path></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 28.182 9.2729\\\" width=\\\"28.182pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.605,0)\\\"></path></g></svg>).</span></span> Met expression showed a positive association with P53 and CD133, whereas YAP expression correlated positively with tumor grade and CD133 (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"></path></g></svg>).</span></span> Pearson’s analysis revealed a significant correlation between Met expression and VEGFR as well as CD133, while YAP expression correlated with Ki67 and VEGFR (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-54\\\"></use></g></svg>).</span></span> Patients with high levels of both Met and YAP exhibited decreased survival time (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-50\\\"></use></g></svg>).</span></span> Furthermore, Met expression, N stage, and VEGFR were identified as independent risk factors for gastric cancer prognosis (<span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 9.2729\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-54\\\"></use></g></svg>),</span></span> whereas no such association was observed for YAP expression. Bioinformatics analysis demonstrated a significant correlation between the expressions of Met and YAP; both proteins were highly expressed in gastric cancer patients accompanied by markedly reduced survival time. <i>Conclusion</i>. The expressions of Met and YAP are closely associated with the survival outcomes as well as clinicopathological features in patients with gastric cancer. Moreover, our findings highlight that Met serves as an independent prognostic factor for gastric cancer.\",\"PeriodicalId\":12597,\"journal\":{\"name\":\"Gastroenterology Research and Practice\",\"volume\":\"44 1\",\"pages\":\"\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-04-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastroenterology Research and Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2024/5591298\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterology Research and Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2024/5591298","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
研究目的本研究旨在探讨 Met 和 YAP 在胃癌中的表达及其对临床预后的影响。研究方法收集 89 例胃癌患者的组织样本和临床数据。使用组织芯片对 Met 和 YAP 的表达进行免疫组化定量分析。采用卡方检验确定 Met 和 YAP 的表达与患者临床病理特征之间的相关性。生存分析采用 Kaplan-Meier 法,多变量生存分析采用 Cox 比例危险模型。生物信息学分析通过从 TCGA 下载芯片数据进行。结果与邻近组织相比,Met和YAP在胃癌组织中的表达水平均明显升高()。Met的表达与P53和CD133呈正相关,而YAP的表达与肿瘤分级和CD133呈正相关()。皮尔逊分析显示,Met的表达与血管内皮生长因子受体(VEGFR)和CD133显著相关,而YAP的表达与Ki67和VEGFR相关()。Met和YAP水平均较高的患者生存时间缩短()。此外,Met表达、N分期和血管内皮生长因子受体被确定为胃癌预后的独立危险因素(),而YAP表达则没有这种关联。生物信息学分析表明,Met 和 YAP 的表达之间存在显著相关性;这两种蛋白在胃癌患者中均高表达,且生存时间明显缩短。结论Met 和 YAP 的表达与胃癌患者的生存结果和临床病理特征密切相关。此外,我们的研究结果突出表明,Met 是胃癌的一个独立预后因素。
Expressions and Clinical Significance of Met and YAP in Gastric Cancer Tissue Microarray
Objective. This study is aimed at investigating the expression of Met and YAP in gastric cancer and their impact on clinical prognosis. Methods. Tissue samples and clinical data were collected from 89 patients with gastric cancer. Immunohistochemistry was performed to quantify the expression of Met and YAP using tissue microarray. The correlation between the expressions of Met, YAP, and clinicopathological characteristics of patients was determined using a chi-square test. Survival analysis was conducted using the Kaplan-Meier method, while multivariate survival analysis was performed using the Cox proportional hazard model. Bioinformatics analysis was carried out by downloading chip data from TCGA. Results. The expression levels of both Met and YAP were significantly higher in gastric cancer tissues compared to adjacent tissues (). Met expression showed a positive association with P53 and CD133, whereas YAP expression correlated positively with tumor grade and CD133 (). Pearson’s analysis revealed a significant correlation between Met expression and VEGFR as well as CD133, while YAP expression correlated with Ki67 and VEGFR (). Patients with high levels of both Met and YAP exhibited decreased survival time (). Furthermore, Met expression, N stage, and VEGFR were identified as independent risk factors for gastric cancer prognosis (), whereas no such association was observed for YAP expression. Bioinformatics analysis demonstrated a significant correlation between the expressions of Met and YAP; both proteins were highly expressed in gastric cancer patients accompanied by markedly reduced survival time. Conclusion. The expressions of Met and YAP are closely associated with the survival outcomes as well as clinicopathological features in patients with gastric cancer. Moreover, our findings highlight that Met serves as an independent prognostic factor for gastric cancer.
期刊介绍:
Gastroenterology Research and Practice is a peer-reviewed, Open Access journal which publishes original research articles, review articles and clinical studies based on all areas of gastroenterology, hepatology, pancreas and biliary, and related cancers. The journal welcomes submissions on the physiology, pathophysiology, etiology, diagnosis and therapy of gastrointestinal diseases. The aim of the journal is to provide cutting edge research related to the field of gastroenterology, as well as digestive diseases and disorders.
Topics of interest include:
Management of pancreatic diseases
Third space endoscopy
Endoscopic resection
Therapeutic endoscopy
Therapeutic endosonography.