伴平滑肌分化的胃肠间质瘤临床病理特征研究

A study on clinicopathological characteristics of gastrointestinal stromal tumors with smooth muscle differentiation

目的探讨伴平滑肌分化的胃肠间质瘤(GISTs)的临床病理特征。方法回顾性分析2016年4月至2019年11月桂林医学院第二附属医院收治的65例GISTs患者的病历资料。所有患者通过手术方法切除病灶,采用免疫组化链霉亲和素-生物素复合物(SABC)法检测平滑肌源性标志物高分子量钙调结合蛋白(H-caldesmon)、结蛋白(desmin)及平滑肌肌球蛋白重链(SMMHC)的表达情况,并分析其表达情况与患者病理特征的关联性。结果65例GISTs中,有43例(66.15%)伴有平滑肌方向分化,其中H-caldesmon阳性30例(46.15%),desmin阳性7例(10.77%),SMMHC阳性6例(9.23%)。H-caldesmon与肿瘤直径、危险分级情况存在显著关联性(P<0.05)。desmin和SMMHC与性别、年龄、肿瘤直径、核分裂数、危险分级等情况均无显著关联(P>0.05)。联合三个指标而言,GISTs伴平滑肌方向分化情况与肿瘤直径、核分裂数和危险分级情况存在显著关联性(P<0.05),而与年龄、性别无显著关联(P>0.05)。结论伴有平滑肌方向分化的GISTs患者可能有较好的预后。

Objective[JP4]To explore the clinicopathological characteristics of gastrointestinal stromal tumors(GISTs)with smooth muscle differentiation.Methods The medical records of 65 patients with GISTs admitted to the Second Affiliated Hospital of Guilin Medical College from April 2016 to November 2019 were retrospectively analyzed.The lesions were surgically excised in all the patients,and the immunohistochemical streptavidin-biotin complex(SABC)method was used to detect the expressions of smooth muscle-derived markers H-caldesmon,desmin and smooth muscle myosin heavy chain(SMMHC).The correlations between their expressions and the patients′pathological characteristics were analyzed.Results Among the 65 cases of GISTs,43 cases(66.15%)were accompanied by smooth muscle differentiation.Of the 43 cases,30 cases(46.15%)were positive for H-caldesmon,7 cases(10.77%)positive for desmin,and 6 cases(9.23%)positive for SMMHC.H-caldesmon was significantly correlated with tumor diameter and risk grade(P<0.05).Desmin and SMMHC were not significantly correlated with gender,age,tumor diameter,mitotic number and risk grade(P>0.05).In combination of the three indicators,GISTs with smooth muscle differentiation were significantly correlated with tumor diameter,mitotic number and risk grade(P<0.05),but were not significantly correlated with age and gender(P>0.05).Conclusion GISTs patients with smooth muscle differentiation may have a better prognosis.