胃肠道间质瘤的免疫组化观察与临床病理意义的研究  

Correlation of pathologic features and immunohistochemical featuares of GISTs

作　　者：林海峰[1] 徐国森[1] 佟丹丹[1,2] 耿敬姝[1] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院病理科,黑龙江哈尔滨150081 [2]哈尔滨医学大学病理教研室,黑龙江哈尔滨150081

出　　处：《现代肿瘤医学》2013年第6期1299-1303,共5页Journal of Modern Oncology

基　　金：黑龙江省自然科学基金(编号:D200921)

摘　　要：目的:探讨胃肠道间质瘤(GIST)的临床病理特点以及CD117、CD34、Desmin、DOG-1、S-100、SMA的表达情况,并分析两者之间的关系。方法:用免疫组化SP法检测62例胃肠道间质瘤组织中CD117、CD34、DOG-1、S-100、SMA的表达情况,分析其与临床病理因素(性别、年龄、生长部位、肿瘤大小、核分裂相、组织学类型)的相关性。结果:62例GIST中极低度危险度13例,低度危险度17例,中度危险度13例,高度危险度19例。62例GIST中CD117阳性(93.55%,58/62),CD34阳性(82.26%,51/62),DOG-1阳性(90.32%,56/62),Desmin阳性(3.23%,2/62),SMA阳性(41.93%,26/62),S-100阳性(19.35%,12/62)。CD34的表达与肿瘤大小以及危险度有关。与DOG-1+/CD117+相比,另外两组(DOG-1+/CD34+,CD117+/CD34+)的共同阳性表达率明显降低。在GIST中,与DOG-1相比,CD117在GISTs的阳性率表达中,没有显著的统计学差异,而CD34则存在统计学差异。结论:DOG-1作为GIST的标志物,在诊断GIST方面,与CD117同样具有较好的特异性和敏感性。同时,CD117、CD34及DOG-1这三个指标对于GISTs的正确诊断以及之后的病人的个体化治疗有着指导意义。Objective：To investigate the clinicopathologic and immunohistochemical features of gastrointestinal stromal tumors（GISTs） and the significance of expression of CD117,CD34,Desmin,DOG-1,SMA,S-100 and analyze their correlation.Methods：The expression of CD117,CD34,Desmin,DOG-1,S-100,SMA was detected by immunohistochemical SP staining in 62 cases of GISTs.The correlation of expression of immunohistochemical features and the clinicopathologic fators（gender,age,tumor location,tumor size,mitotic phase,histotype） and risk degree of GISTs was analyzed.Results： The rate of the lowest risk tumor was 20.97%（13/62）,and the low risk tumor was 27.42%（17/62）.The rate of the midrange risk tumor was 20.97%（13/62）,and the high risk tumor was 30.65%（19/62） respectively.The positive rates of CD117 and CD34 were 93.55%（58/62） and 82.26%（51/62）.The positive rates of DOG-1 and Desmin were 90.32%（56/62） and 3.23%（2/62）.The positive rates of SMA and S-100 were 41.93%（26/62） and 19.35%（12/62）.The expression of SMA,S-100 and Desmin had no significant association with gender,age,tumor location,tumor size,mitotic phase,histotype,or risk degree,so were CD117 and DOG-1,while the expression of CD34 was related with tumor size and risk degree（P0.05）.Compared with DOG-1＋/CD117＋,another two groups＇（DOG-1＋/CD34＋,CD117＋/CD34＋） co-positive rate decreased clearly.Compared with DOG-1,there was no significant statistical differences with CD117,and there are statistically significant differences with CD34.Conclusion：DOG-1,as a marker,is distinctive and sensitive in GIST diagnosis.The combination detection of immunohistochemical features is necessary for decide the patients diagnosis and individual treatment.

关 键 词：胃肠道间质瘤 CD117 CD34 DOG-1 SMA S-100 DESMIN 临床病理特征 

分 类 号：R735.2[医药卫生—肿瘤] R735.3[医药卫生—临床医学]