CD117阴性胃肠道间质瘤的临床病理及超微结构分析

Clinicopathological and ultrastructural analysis of gastrointestinal stromal tumours negative for CD117

目的:探讨CD117阴性胃肠道间质瘤(gastrointestinal stromal tumours,GIST)的临床病理及超微结构特征.方法:采用HE、免疫组化(EnVision法)及电镜技术观察16例CD117阴性GIST,并运用Western blot技术检测4例GIST中PKC-θ蛋白的表达.结果:16例患者中男11例,女5例,年龄32～67柳岁,平均54岁.随访9例,死亡1例.组织学形态可分为梭形细胞为主型、上皮样细胞为主型及梭形和上皮样细胞混合型.肿瘤细胞免疫组化阳性表达为PKC-θ87.5%(14/16),CD117 0%(0/16),CD34 62.5%(10/16),Des 6.2%(1/16),θ-SMA 31.2%(5/16),S-100 18.8%(3/16).电镜下GIST的超微结构特点与卡哈尔细胞相似.Western blot证实了PKC-θ在CD117阴性GIST中的表达.结论:CD117阴性GIST可通过免疫标记PKC-θ和及电镜检测做出诊断.

Objective:To investigate the clinicopathological and ultrastructural features of gastrointestinal stromal tumours (GIST) negative for CD117.Methods: Sixteen cases of GIST negative for CD117 were investigated with HE staining,EnVision immunostaining and electron microscopy.Western blot was used to test the expression of PKC-θ on 4 cases of GIST.Results:Eleven patients were male and five were female,32~67 years in age(average 54 years).Nine patients were followed up and one was dead.GIST tended to fall into three categories of morphology: spindle,epithelioid and mixed cell.Immunohistochemically,the tumours were positive for PKC-θ 88%(14/16),CD117 0%(0/16),CD34 63%(10/16),Des 6%(1/16),θ-SMA 31%(5/16) and S-100 19%(3/16) respectively.The ultrastructural feature of one case was similar to that of the interstitial cell of Cajal(ICC).Western blot confirmed the expression of PKC-θ on GIST negative for CD117.Conclusion:GIST negative for CD117 could be diagnosed by immunohistochemistry for PKC-θ and ultrastructural findings.