胃肠道间质瘤组织ETV1表达临床意义探讨

Expression of ETV1 and its clinical significance in tissue of gastrointestinal stromal tumor

目的:探讨ETV1蛋白在胃肠道间质瘤(gastrointestinal stromal tumor,GIST)组织中的表达及其临床意义。方法:收集山西医科大学第一医院2009-01-01-2012-06-30经外科切除的GIST组织标本84例,同时收集同院同期6例食管平滑肌瘤、3例胃神经鞘瘤、3例肠系膜神经纤维瘤、5例腹腔精原细胞瘤、5例胸腺瘤及10例正常胃肠道黏膜组织作为对照。应用免疫组织化学Polymer conjugate方法检测ETV1在GIST肿瘤组织和对照组组织中的表达,并与CD117和CD34标志进行比较观察。结果:ETV1、CD117和CD34在84例GIST组织中阳性表达率分别为96.4%(81/84)、100.0%(84/84)和76.2%(64/84),对照组真性平滑肌瘤、神经鞘瘤、纤维瘤病、精原细胞瘤、胸腺瘤及正常胃肠道黏膜组织中均未检测到ETV1蛋白的表达。CD117在精原细胞瘤和胸腺瘤中呈阳性表达,在平滑肌瘤、神经鞘瘤和神经纤维瘤中为阴性表达;CD34在对照组2例神经鞘瘤、1例神经纤维瘤中呈阳性表达,其余为阴性。ETV1在GIST中呈现不同程度的表达,表达强度与患者性别、年龄、肿瘤部位、病理形态及生物学行为无相关性,P>0.05。84例GIST中,ETV1表达与CD117表达基本呈一致性;ETV1与CD34的表达无相关性,χ2=0.972,P=0.324,r=0.107。ETV1标志GIST的敏感性(96.4%)与CD117相近(100.0%),明显高于CD34(76.2%);而特异性达100.0%,高于CD117(54.5%)和CD34(86.4%)。结论:ETV1是一种新的诊断GIST较特异标志,与CD117联合应用有望进一步提高GIST的诊断水平。

OBJECTIVE： To investigate the expression of ETV1 in gastrointestinal stromal tumors（GIST）and its clinical significance. METHODS： Immunohistochemical polymer conjugate technique was used to assess the expression of ETV1 in 84 cases of GIST and 22 cases of controls in comparison with CDl17 and CD34. RESULTS： The positive expres sion rates of ETV1,CD117 andCD34 were 96.4%（81/84）,100.0%（84/84） and 76. 2%（64/84）. In the group of true leiomyomas,schwannomns,fibromatosis, seminoma, thymoma and normal gastrointestinal mucosa there were no expres sions of ETV1. CDll7 was positively expressed in seminoma and thymoma, negatively expressed in true leiomyomas, schwannoma,neurofibroma,however. CD34 was positively expressed in two schwannoma and one neurofibroma case, but negatively expressed in other control cases. The different level of ETV1 expression was detected in GIST, the expression intensity was not correlated with sex, age, location, pathological feature and biological behaviour （P〉0.05）. The expression of ETV1 was concordance with CDl17. There was no correlation between the expression of ETV1 and CD34 （ z = 0. 972,P=0. 324,r=0. 107）. Moreover the sensitivity of ETV1 （96.4%）in the detection of GIST were similar to those of CDl17 and significantly higher than those of CD34 （76.2 % ）. The specificity of ETV1 （100.0 %） was higher than those of CDl17 （54.5 % ） and CD34 （86.4% ）. CONCLUSION： ETV1 is a novel marker of gastrointestinal stromal tumors. Combined ETV1 and CD117 immunohistochemistry will likely improve the diagnostic accuracy of GIST.