中高危胃肠道间质瘤患者组织中CD117、DOG-1、CD34、Ki67表达水平及临床意义  

Analysis of CD117, DOG-1, CD34 and Ki67 expression levels, clinical significance and prognostic influencing factors in patients with intermediate- and high-risk gastrointestinal stromal tumors

作　　者：郑雷[1] 于宏伟 金丹雯 钱立勇[1] ZHENG Lei;Yu Hongwei;Jin Danwen(Zhoushan Hospital,Zhejiang 316021,China.)

机构地区：[1]浙江省舟山医院,舟山316021

出　　处：《浙江创伤外科》2024年第1期14-17,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探讨CD117、DOG-1、CD34、Ki67在中高危胃肠道间质瘤(gastrointestinal stromal tumors,GIST)中的表达水平、临床意义及其预后影响因素。方法回顾性研究2015年1月至2018年1月至本院就诊的82例中高危胃肠道间质瘤患者,检测CD34、DOG-1、CD117、Ki67免疫组化标志物,分析患者一般情况、病理学特征、组织学表现、免疫组化结果以及1、3、5年总体生存期(overall survival,OS)和无复发生存期(recurrence-free survival,RFS),研究患者5年OS、RFS的影响因素。结果82例胃肠道间质瘤患者CD117、DOG-1、Ki67阳性分别为95.12%(78/82)、96.34%(79/82)、93.90%(77/82),明显高于D34阳性75.61%(62/82),差异有统计学意义(P<0.05)。1、3、5年OS分别为0%(0/82)、3.66%(3/82)、12.20%(10/82),1、3、5年RFS分别为2.44%(2/82)、28.05%(23/82)、76.83%(63/82)。单因素预后分析提示核分裂数、性别与OS的差异存在统计学意义(P<0.05);年龄、靶向用药、破裂情况、肿瘤部位、危险度、Ki67指数、细胞形态与OS、RFS的差异均有统计学意义(P<0.05);各免疫组化蛋白的指数与OS、RFS的差异无统计学意义(P>0.05)。结论免疫组化标志物是明确GIST诊断的指标,核分裂数、靶向用药、Ki67指数等与GOST预后有相关性,免疫组化蛋白在确诊、估测和治疗GIST方面有显著优势,有益于改善患者预后情况。Objective To investigate the expression level,clinical significance and prognostic factors of CD117,DOG-1,CD34 and Ki67 in gastrointestinal stromal tumors(GIST).Methods A retrospective study was conducted in 82 patients with intermediate and high-risk gastrointestinal stromal tumors from January 2015 to January 2018 admitted to our hospital.CD34,DOG-1,CD117 and Ki67 immunohistochemical markers were detected,and the general condition,pathological features,histological manifestations,immunohistochemical results,overall survival(OS)and recurrence-free survival of 1,3 and 5 years were analyzed,and to study the influencing factors of OS and RFS in patients for 5 years.Results The positive rate of CD117,DOG-1 and Ki67 were 95.12%(78/82),96.34%(79/82)and 93.90%(77/82),respectively,which were significantly higher than that of D3475.61%(62/82),and the difference was statistically significant(P<0.05).The 1-,3-,and 5-year OS was 0%(0/82),3.66%(3/82),and 12.20%(10/82),and the 1-,3-,and 5-year RFS was 2.44%(2/82),28.05%(23/82),and 76.83%(63/82),respectively.Univariate prognostic analysis showed that there were significant differences in nuclear fission number,sex and OS(P<0.05),age,targeted medication,rupture,tumor location,risk,Ki67 index,cell morphology,OS and RFS were statistically significant(P<0.05),and the differences between the indices of immunohistochemical proteins and OS and RFS were not significant(P>0.05).Conclusion Immunohistochemical markers are indicators for the diagnosis of GIST,and the number of nuclear fissions,targeted drugs,and Ki67 index are correlated with the prognosis of GOST,and immunohistochemical proteins have significant advantages in the diagnosis,estimation and treatment of GIST,which is beneficial to improve the prognosis of patients.

关 键 词：胃肠道间质瘤 免疫组化 临床特点 预后 

分 类 号：R735.2[医药卫生—肿瘤]