胃肠间质瘤315例临床病理及免疫组化分析
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摘要
目的:探讨胃肠间质瘤(GIST)的临床病理特点及免疫组化特征。方法:收集315例GIST患者的临床资料和免疫组化结果。结果:315例GIST患者中,男性略多于女性,约2/3位于胃,其余发生于小肠、大肠及肠系膜。病理类型以梭形细胞型为主,部分为上皮样细胞型,少数为上皮样-梭形细胞混合型。69例为极低危险度,73例为低危险度,93例为中等危险度,56例为高危险度,24例为恶性GIST。33例合并食管鳞状细胞癌,24例合并胃腺癌,23例合并结直肠腺癌,1例合并胃弥漫性大B细胞淋巴瘤。免疫组化:311例CD117(+),314例Dog-1(+),227例CD34(+),56例SMA(+),12例S-100(+),6例Desmin(+)。结论:GIST主要发生于胃,其次是小肠,联合检测CDll7、Dog-l和CD34可提高GIST的诊断率。
Objective:To investigate the clinicopathological and immunohistochemical features of gastrointestinal stromal tumors(GIST). Methods: Collect clinical data and immunohistochemical results of 315 cases of surgical GIST in Hospital. Results:315 cases GIST, there were slightly more males than females. About 2/3 are located in stomach and the rest occurs in the small intestine, large intestine and mesenteric. The pathological type was mainly spindle cell type, partly epithelial-like cell type, and a few were epithelial-like spindle-shaped cell mixed Type. There were 69 cases extremely low risk degree, 73 cases were low risk degree, 93 cases were medium risk degree, 56 cases were high risk degree, and 24 cases were malignant GIST. 33 cases with esophageal squamous cell carcinoma, 24 cases with gastric adenocarcinoma, 23 cases with colorectal adenocarcinoma and 1 case with gastric diffuse large B-cell lymphoma. Immunohistochemistry: the expression rates of CD117,Dog-1,CD34,SMA,S-100 and Desmin protein were 98.7%(311/315),99.9%(314/315),72.1%(227/315),17.8%(56/315),3.8%(12/315) and 1.9%(6/315).Conclusion: GIST mainly occurs in stomach, followed by the small intestine, combined detection of CD117, Dog-l and CD34 can improve the diagnostic rate of GIST.
Objective:To investigate the clinicopathological and immunohistochemical features of gastrointestinal stromal tumors(GIST). Methods: Collect clinical data and immunohistochemical results of 315 cases of surgical GIST in Hospital. Results:315 cases GIST, there were slightly more males than females. About 2/3 are located in stomach and the rest occurs in the small intestine, large intestine and mesenteric. The pathological type was mainly spindle cell type, partly epithelial-like cell type, and a few were epithelial-like spindle-shaped cell mixed Type. There were 69 cases extremely low risk degree, 73 cases were low risk degree, 93 cases were medium risk degree, 56 cases were high risk degree, and 24 cases were malignant GIST. 33 cases with esophageal squamous cell carcinoma, 24 cases with gastric adenocarcinoma, 23 cases with colorectal adenocarcinoma and 1 case with gastric diffuse large B-cell lymphoma. Immunohistochemistry: the expression rates of CD117,Dog-1,CD34,SMA,S-100 and Desmin protein were 98.7%(311/315),99.9%(314/315),72.1%(227/315),17.8%(56/315),3.8%(12/315) and 1.9%(6/315).Conclusion: GIST mainly occurs in stomach, followed by the small intestine, combined detection of CD117, Dog-l and CD34 can improve the diagnostic rate of GIST.
引文
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[2]中国临床肿瘤学会胃肠间质瘤专家委员会.中国胃肠间质瘤诊断治疗共识(2017版)[J].肿瘤综合治疗电子杂志,2018,4(1):31~43.
[3]Nannini M,Biasco G,Astolfi A,et al.An overview on molecular biology of KIT/PDGFRA wild type(WT)gastrointestinal stromal tumours(GIST)[J].J Med Genet,2013,50(10):653~661.
[4]付娟娟,宋新兰,贺家勇,等.胃肠道间质瘤的临床病理特征分析及免疫组化研究[J].新疆医科大学学报,2011,34(2):155~157.
[5]Espinesa I,Lee C H,Kim M K,et al.A novel monoclonal antibody against DOG1 is a sensitive and specific marker for gastrointestinal stromal tumors[J].AM J Surg Pathol,2008,32(2):210~218.
[6]赵晶洁,张学东,李建华,等.新型胃肠道间质瘤标志物DOG-1的应用与探讨[J].广东医学,2010(31):896~898.
[7]赵文娣,祁义军,王岳君,等.胃肠道间质瘤临床病理及免疫组化表达的分析[J].安徽医科大学学报,2012,47(4):454~457.