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目的 探讨不同部位胃肠道间质瘤(gastrointestinalstromaltumors,GIST)免疫组化表达谱的一般规律及变异。方法 用CD117、CD34、α-SMA、S 100蛋白等抗体对205例GIST进行免疫组化染色。结果 CD117在原发性GIST中总阳性率为96 6%,阳性表达与部位无关,CD34在消化道不同部位GIST阳性率分别为食管(3 /3)、胃88 5% (108 /122)、小肠42 .9% (21 /49)、结肠66 7% (2 /3)、直肠100% (28 /28),小肠GISTCD34阳性率最低,与其它部位比较差异有显著性(χ2 =52 50,P<0 001)。α-SMA、MSA在不同部位GIST中的表达呈现与CD34相反的规律,小肠阳性率最高,分别为40. 8% ( 20 /49 ) (χ2 =11 47,P<0 01)和26 5% (13 /49),GIST中desmin偶尔局灶阳性(2 2% ),S 100蛋白、PGP9 5总阳性率为17. 0%和12. 5%,均以小肠阳性率较高,分别为24. 5%和22. 4%。结论 CD34、αSMA、MSA以及S 100蛋白、PGP9 5在GIST中的表达与GIST的部位有关,了解此规律对避免将表达αSMA、MSA的小肠GIST诊断为平滑肌肿瘤具有重要参考价值。此组抗原谱在GIST的变化规律可能与消化道不同部位卡哈尔间质细胞(interstitialcellsofCajal,ICC)的内在特征有关。
Objective To investigate the general rules and variations of immunohistochemical expression profiles of gastrointestinal stromal tumors (GISTs) in different sites. Methods Totally 205 GISTs were immunohistochemically stained with antibodies such as CD117, CD34, α-SMA and S 100. Results The positive rate of CD117 in primary GIST was 96 6%. The positive expression of CD117 was not related to the site. The positive rates of GIST in different parts of the digestive tract were esophagus (3/3), gastric 88% (108/122) The positive rate of GISTCD34 was the lowest in 42.9% (21/49) of the small intestine, 66.7% (2/3) of the colon and 100% (28/28) of the rectum, and the difference was statistically significant with other sites (χ2 = 52 50, P <0 001). The positive rates of α-SMA and MSA in GIST at different sites showed the opposite trend to that of CD34, with the highest positive rates of small intestine (40.8% (20/49) (χ2 = 1147, P <0.01) (13/49). The positive rates of desmin in occasional focal lesions (22%), S 100 protein and PGP9 5 in GIST were 17.0% and 12.5% 5% and 22.4%. Conclusions The expression of CD34, αSMA, MSA, S 100 protein and PGP9 5 in GIST is related to the location of GIST. Understanding this pattern is of important value in the diagnosis of small intestinal GISTs expressing α SMA and MSA. The changes of antigenic spectrum in this group may be related to the intrinsic features of interstitial cells of Cajal (ICC) in different parts of the digestive tract.