胃肠道间质瘤临床病理及免疫组化表达的分析

目的探讨胃肠道间质瘤(GIST)的临床病理和免疫组织化学特征。方法回顾性分析181例经手术治疗的GIST患者临床病理资料,并检测CD117、DOG1、CD34、SMA、Desmin、S100的表达。结果 GIST形态学表现以梭形细胞型为主。CD117、DOG1、CD34、SMA、Desmin、S100阳性表达率分别为:91.2%、89.5%、77.9%、35.6%、6.1%、11.0%。CD117与DOG1阳性表达一致率为83.4%(151/181),DOG1在68.8%(11/16)的CD117阴性GIST中阳性表达。GIST组织中仅DOG1的阳性表达与患者年龄、肿瘤大小、危险度分级有关(P<0.05),其他标记物与GIST临床病理因素均无关。结论 CD117和DOG1是诊断GIST敏感而有效的指标,联合检测CD117、CD34和DOG1可提高GIST诊断的准确率;SMA、Desmin、S100是重要的鉴别诊断指标;DOG1阴性表达可能提示GIST预后不良。

Clinicalpathological and immunohistochemical study of gastrointesitinal stromal tumors

Objective To investigate the clinicalpathological and immunohistochemical features of gastrointestinal stromal tumors(GIST).Methods The medical records of 181 patients underwent surgical resection for GIST were reviewed.Immunohistochemical staining of CD117,DOG1,CD34,SMA,Desmin,S100 was performed in 181 cases of GIST.Results The major morphology of GIST was spindle-shaped.The positive rates of CD117,DOG1,CD34,SMA,Desmin,S100 were 91.2%,89.5%,77.9%,35.6%,6.1%,11.0% respectively.There were 83.4%(151/181)tumors positive for both CD117 and DOG1.68.8%(11/16)tumors positive for DOG1while negative for CD1117.The immunohistochemical expression of DOG1 was significantly related with age,tumor size and risk classification(P<0.05).Conclusions Spindle-shaped is the major morphology of GIST.CD117 and DOG1 are sensitive and effective markers for GIST.Combined detection of CD117,DOG1 and CD34 may improve the diagnosis of GIST.SMA,Desmin and S100 play an important role in the differential diagnosis of GIST.Negtive expression of DOG1 may suggest an poor prognosis.