DOG1、CD117和PDGFRA在胃肠道间质瘤中的表达及相关性

Expression of DOG1,CD117 and PDGFRA in gastrointestinal stromal tumors

目的:探讨DOG1、CD117和血小板衍生生长因子受体α(PDGFRA)在胃肠道间质瘤(GISTs)诊断中的意义,并分析与其GISTs临床病理因素和危险度的关系.方法:应用免疫组织化学Envision二步法检测63例GISTs及43例非GISTs间叶源性肿瘤患者中DOG1、CD117及PDGFRA的表达,并分析上述免疫组织化学指标与临床病理因素(性别、年龄、部位、肿瘤大小、核分裂象、组织学类型)和危险度的相关性.结果:GISTs中DOG1、CD117和PDG-FRA阳性表达率分别为84.13%(53/63)、90.48%(57/63)、52.38%(33/63),DOG1、CD117与PDGFRA相比,差异显著(均P<0.01),而其中CD117阴性的6例GISTs均表达DOG1阳性,5例表达PDGFRA阳性;非GISTs间叶源性肿瘤中DOG1、CD117及PDGFRA阳性表达率分别为11.63%、16.28%、6.98%.DOG1及PDGFRA的表达在不同性别、年龄、部位、肿瘤大小、核分裂象、组织学类型之间没有显著性差异,与危险度亦无相关性.但CD117的表达与部位及组织学类型有关(P=0.008,0.045),其他部位(肠系膜、腹腔、网膜)CD117表达率低于胃、小肠、结肠及直肠(50.00%vs94.74%,P=0.008).且梭型及上皮型中CD117高表达.结论:DOG1和CD117可以作为GISTs诊断的特异性标志物;对于KIT阴性的GISTs,DOG1检测的加入,将在病理学和临床上进一步完善诊断依据;DOG1、CD117和PDGFRA不能作为判断危险度的指标.

AIM：To investigate the significance of expression of discovered on GIST-1（DOG1）,CD117 and platelet-derived growth factor receptor alpha（PDGFRA） in gastrointestinal stromal tumors（GISTs） by analyzing their correlation with clinicopathologic features and risk degree of GISTs.METHODS：The expression of DOG1,CD117 and PDGFRA was detected by immunohistochemistry in 63 cases of GISTs and 43 cases of non-GISTs.The correlation of expression of DOG1,CD117 and PDGFRA with clinicopathologic factors and risk degree of GISTs was then analyzed.RESULTS：The positive expression rates of DOG1,CD117 and PDGFRA in GISTs were 84.13%（53/63）,90.48%（57/63） and 3.17%（33/63）,respectively.The positive expression rates of DOG1 and CD117 in GISTs were significantly higher than that of PDGFRA（both P 0.01）.Of six CD117-negative cases,all were positive for DOG1 and five positive for PDGFRA.The positive expression rates of DOG1,CD117 and PDGFRA in patients with non-GISTs were 11.63%,16.28% and 6.98%,respectively.The expression of DOG1 and PDGFRA had no significant association with gender,age,tumor location,tumor size,mitotic phase,histotype,or risk degree,while the expression of CD117 was related with tumor location and histotyoe（P = 0.008,0.045）.Tumors derived from the mesentery,abdominal cavity and epiploon had higher positive rates of CD117 than those derived from the stomach,small intestine,colon and rectum（50.00% vs 94.74%,P = 0.008）.CD117 was highly expressed in spindle-cell and epithelial-cell types.CONCLUSION：Both DOG1 and CD117 are highly expressed in GISTs and can serve as specific diagnostic markers for GISTs.DOG1 has a good sensitivity and specificity in the diagnosis of GISTs,especially KIT-negative GISTs.Detection of DOG1,CD117 and PDGFRA expression can not be used for assessing the risk degree of GISTs.