肠系膜纤维瘤、孤立性纤维性肿瘤和胃肠道间质瘤的免疫组织化学观察

目的：探讨肠系膜纤维瘤（MF）、孤立性纤维性肿瘤（SFT）和胃肠道间质瘤（GIST）的免疫组织化学鉴别诊断。方法：运用组织芯片结合免疫组织化学技术对3种肿瘤进行CD117、CD34、β-catenin、S-100、Desmin、Bcl-2和Dog-1的免疫组织化学分析。结果：75%的MF为β-catenin阳性表达,而13例GIST和7例SFT均为阴性表达;85%的GIST为CD117阳性表达,92%的GIST为Dog-1阳性表达,25%的MF为Dog-1阳性表达,8例MF均为CD117阴性表达,7例SFT则CD117和Dog-1均为阴性表达;71%的SFT表达CD34和Bcl-2,而23%的GIST表达为CD34阳性。结论：组合应用CD117（或Dog-1）、CD34和β-catenin并结合HE染色切片的形态特点可以有效地鉴别深部MF、SFT和GIST。配合应用S-100和Desmin,可以进一步排除肌源性和外周神经源性肿瘤。

Immunohisochemical differential diagnosis of mesenteric fibromatosis, solitary fibrous tumors and gastrointestinal stromal tumors

Objective： To study the immunohistochemical features and the differential diagnosis of mesenteric fibromatosis （MF）, solitary fibrous tumors （SFT）and gastrointestinal stromal tumors （GIST）. Methods： The expressions of CD117, CD34, β-catenin, S-100, Desmin, Bcl-2 and Dog-1 of the three tumors were studied by immunohistochemistry method （S-P method）. Results： By immunohistochemical staining detection, the expression of β-catenin in six MF cases were positive, the positive expression rates of CD117 and Dog-1 in GIST cases were 85% and 92% respectively, and the positive expression rates of CD34 and Bcl-2 in SFT were 71% . Conclusion： MF, SFT and GIST can be identified by the combining applying of CD117,CD34 and β-catenin through the immunohistochemistry method.