胃肠道间质细胞瘤CD117、Nestin和Ki-67表达及其临床意义/

2019-05-11 07:15:36

Ki 67 间质 Nestin CD117



目的:本研究通过对27例胃肠道间质细胞瘤标本进行光镜观察及CD117,Nestin,Ki-67免疫组织化学检测,探讨胃肠道间质细胞瘤免疫组化的结果与临床意义之间的关系
方法:所有标本均经10%甲醛固定,常规石蜡包埋切片(厚度3μm),H-E染色,光镜观察。S-P法检测CD117、Nestin和Ki-67的表达情况,用已购阳性切片作阳性对照,PBS代替一抗作为阴性对照,DAB 显色,苏木精复染,显微镜下观察结果。检测27例胃肠道细胞间质瘤组织中CD117、Nestin 和Ki-67的表达情况。参照Lewin等提出的标准,将胃肠道细胞间质瘤分为良性间质瘤、潜在恶性间质瘤、恶性间质瘤。并分析上述免疫组化指标与临床病理相关因素(性别、年龄、发生部位、组织学分型) 和良恶性之间的关系。
结果:27例胃肠道间质细胞瘤中CD117和Nestin的阳性表达分别为24例(88.9%)和25例(92.6%),Ki-67增殖指数<1%、1%~5%和>5%的例数分别为7例、9例和11例;CD117、Nestin和Ki-67在不同性别、年龄、组织学分型之间均无统计学意义(P>0.05)。良性,潜在恶性,恶性的病例分别为6例、9例和12例,CD117和Nestin 的阳性表达率在不同的肿瘤分级之间无统计学意义(P>0.05),而Ki-67增殖指数在不同的肿瘤分级之间存在显著性差异(P<0.01)。
结论:1、CD117和Nestin在胃肠道间质细胞瘤的阳性率分别为88.9%和92.6%,CD117 、Nestin的敏感性、特异性、可靠性均较好,CD117、Nestin的联合应用有助于提高胃肠道间质细胞瘤诊断的准确率。2、CD117和Nestin的阳性表达率在不同的良恶性胃肠道间质细胞瘤之间无统计学意义,CD117和Nestin不能作为诊断胃肠道间质细胞瘤良恶性的指标。3、本研究结果显示:Ki-67的增殖指数在不同良恶性胃肠道间质细胞瘤之间具有显著性差异,增殖指数越高,胃肠道间质细胞瘤的恶性程度也越高。

关键词:胃肠道间质细胞瘤;CD117;Nestin;Ki-67




Objective: To investigate the expression of CD117, Nestin and Ki-67 in gastrointestinal stromal tumors (GIST) and its relationship with the clinicopathological features and distinguishing malignant from benign of GIST.
Methods: The expression of CD117, Nestin and Ki-67 was detected with S-P staining and distinguishing malignant from benign in all cases based on the observations of light microscopy.Then the correlation between immunohistochemical findings and the clinicopathological features (gender, age,location and histological type) and distinguished malignant from benign of GIST were analyzed.
Results : Of 27 GIST, the positive rates of CD117 and CD34 were 88.9% and 92.6% , respectively. The Ki-67 proliferation indices were <1 % , 1 %-5 % and >5 % in 7, 9 and 11 patients , respectively. Expression of CD117, CD34 and Ki-67 had no significant difference between groups in gender, age and histological types. The number of patients at benign, potential malignant and malignant was 6,9 and 12, respectively. Further data showed that expression of CD117 and Nestin proteins had no significant difference between different benign and malignant. Nevertheless , Ki-67 protein had higher expression in higher risk cases ( P<0.01).
Conclusion: CD117 and Nestin, both highly expressed in GIST, can serve as diagnostic markers for GIST, but can not be used for assessing the risk of patients. The expression of Ki-67 protein might be a risk indicator for GIST and a predictor for prognosis.
Key words: gastrointestinal stromal tumors ; CD117 ; Nestin; Ki-67;