胃肠道间质瘤神经分化及良恶相关性研究

STUDY ON CORRELATION BETWEEN NEURO-DIFFERENTIATION AND BIOLOGICAL BEHAVIOR OF GASTROINTESTINAL STROMAL TUMOR

目的:探讨恶性GIST与神经分化的相关性,以期加深对该瘤的认识和有助于提升术前病理诊断水平。方法:按Lewin提出的标准判断GIST的良恶性,应用组织芯片技术作免疫组化(S-P法)对50例胃肠道间质瘤检测SMA、NSE。结果:良性15例,NSE表达11例、SMA表达7例,其中双向表达6例,5例均不表达;恶性20例,NSE表达17例、SMA表达13例,其中双向表达11例,1例均不表达;潜在恶性15例,NSE表达13例、SMA表达6例,其中双向表达5例,1例均不表达;良性、潜在恶性、恶性NSE表达率分别为73%、87%、85%,SMA表达率分别为47%、40%、65%。结论:GIST可分别或同时表达SMA、NSE,少数均不表达;GIST神经分化(或肌源性分化)与其良恶无显著相关性。

Objective：To study and discuss the relationship between malignanty of gastrointestinal stromal tumor （GIST） and its neuro-differentiation. So as to deepen the recognition of it and to promote the preoperative diagnosis.Methods：The SMA,NSE were examined by immunohistochemistry（S-P） with tissue array on 50 cases of GIST which were grouped based on the Lewin＇s criteria for diagnosis of benign and malignant GIST .Results：iS cases were benign,20 were malignant and 15 were potentially malignant.In benign cases, the positive expression of NSE were ll,that of SMA were 7,among them both expression were 6 cases,Scases had no expression. In malignant cases, the positive expression of NSE were 17,that of SMA were 13, among them both expression were 11 cases, only one had no expression. In potentially malignant cases, the positive expression of NSE were 13,that of SMA were 6,among them both expression were 5cases,one had no expression.The positive expression rates of NSE in benign cases, potentially malignant ones and malignant ones were 73%,87% and 85% respectively. The positive expression rates of SMA were 47%, 40% and 65% respectively. Conclusion：The SMA,NSE may be expressed separately or concurrently in GIST. A few cases have no expression. Of them, from the statistical result,the neuro- differentiation of GIST has no correlation to their biological behavior .