胃肠道间质瘤免疫表型的表达及临床意义

目的:观察胃肠道间质瘤（GIST）免疫表型的表达，分析其在诊断上的临床意义，探讨其与危险度分级的关系。方法:吉林大学第一医院病理科2010 年 12 月至 2012 年 8月检测的GIST术后标本65 例，采用免疫组化SP法检测CD117、CD34、DOG1、SMA、S-100、Ki-67和Desmin的表达，应用SPSS 17.0对数据进行分析，探讨相关免疫表型与临床病理相关因素的关系。结果:65例GIST中DOG1、CD117、CD34 的阳性率分别为100.0%、96.9%、89.2%。CD34在胃GIST的阳性表达高于小肠GIST(P＜0.05)，SMA在小肠GIST的阳性表达高于胃GIST(P＜0.05)，Ki-67的表达与肿瘤大小、核分裂相、危险度分级相关。结论:CD117联合CD34、DOG1检测可以提高GIST的诊断率；SMA在小肠GIST中表达率明显高于胃GIST的表达，CD34在胃GIST中表达率高于小肠GIST的表达；Ki-67可以作为一个判定GIST预后的指标。

Expression of immunophenotype in gastrointestinal stromal tumors and the clinical significance

Objective:To analyse the expression and diagnositic significance of immunophenotype in gastrointestinal stromal tumors,to discuss the relationship of risk degree and prognosis with the immunophenotype.Methods:Sixty-five patients were diagnosed as GIST(gastrointestinal stromal tumors) in First Hospital of Jilin University from December 2010 to August 2012.The expression of CD117,CD34,DOG1,SMA,S-100,Ki-67 and Desmin were tested by immunohistochemical SP method.Results:The positive rates of DOG1，CD117 and CD34 Desmin were 100.0%，96.9%，89.2% in GIST.The positive rate of CD34 in stomach was higher than that in small intestine(P＜0.05),while the positive rate of SMA in small intestine was higher than that in stomach(P＜0.05).The expression of Ki-67 was positively correlated with the risk degree and mitosis count.Conclusion:Detection of CD117 combined with CD34 and DOG1 can improve the diagnostic rate.S-100,SMA and Desmin was rarely expressed,the focal expressions of which can distinguish from neurogenic tumor and smooth muscle tumor.The expression of CD34 in stomach is higher than that in small intestine,while the expression of SMA in small intestine is higher than that in stomach.The expression of Ki-67 was positively correlated with tumor size,risk degree and mitosis count.Ki-67 is an indicator in the diagnosis of GIST.