nestin在胃肠道间质瘤病理诊断中的价值

目的探讨nestin在胃肠道间质瘤（gastrointestinal stromal tumors，GISTs）辅助诊断中的价值。方法用免疫组化EnVision法检测96例CD117阳性、5例CD117阴性的GISTs，以及食管平滑肌瘤（10例）、消化道雪旺瘤（33例）、肠纤维瘤病（6例）以及腹腔平滑肌肉瘤（15例），观察这些肿瘤中nestin的表达状况。结果96例CD117阳性的GISTs中，94例表达nestin，其中70例弥漫强表达，21例中度阳性，3例局灶阳性，仅2例阴性；5例CD117阴性的GISTs中，4例表达nestin；33例消化道雪旺瘤中26例表达nestin；15例平滑肌肉瘤中3例局灶表达nestin；10例食管平滑肌瘤、6例肠纤维瘤病均为阴性。结论nestin是辅助诊断GISTs的新指标，可鉴别GISTs与平滑肌肿瘤和纤维瘤病，但在GISTs与雪旺瘤的鉴别中需结合S-100蛋白等指标。

Nestin:a novel marker in additional diagnosing gastrointestinal stromal tumors

Purpose To study the nestin in the diagnosis of gastrointestinal stromal tumors. Methods There were 165 cases of mesenchymal tumors were investigated the expression of nestin by immunohistochemistry, including 96 CD117-positive GISTs,5 CD117-negtive GISTs,10 oesophagus leiomyomas,33 digestive tract Schwannomas,6 fibromatosis and 15 leiomyosarcomas in abdominal cavity. Results Among 96 cases of CD117-positive GISTs, 94 positive for nestin(in amount of this 70 diffusive positive, 21 moderate positive, 3 local positive), the other two were negative. 4 of the 5 CD117-negative GISTs and 26 of 33 Schwannomas expressed nestin too, only 3 of 15 leiomyosarcomas showed focal positive for nestin. All oesophagus leiomyomas and fibromatosis of intestinal demonstrated negativity for nestin. Conclusions Nestin is a novel marker for GISTs following CD117,It could be efficient in the differerntial diagnosis between GISTs and leiomyomas or fibromatosis. However, other antibody such as S-100 should be used in the differential diagnosis between GISTs and Schwannomas.