CD117阴性胃肠道间质瘤的临床病理及超微结构

摘要

目的:探讨CD117阴性胃肠道间质瘤(gastrointestinal stromal tumours,GISTs)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GISTs.结果:16例患者中11例男性,5例女性,年龄32-67岁,平均54岁.随访9例,1例死亡.组织学形态可分为梭形细胞为主型、上皮样细胞为主型以及梭形和上皮样细胞混合型三类.肿瘤细胞免疫组化阳性表达为DOG1 81.2%(13/16),CD117 0%(0/16),CD34 63%(10/16),Des 6%(1/16),α -SMA 31.3%(5/16),S-100 12.5%(2/16).电镜下GISTs的超微结构特点与卡哈尔细胞相似.结论:CD117阴性GISTs可通过免疫标记DOG1及电镜检测做出诊断.%Objective : To investigate the clinicopathological and ultrastructural features of gastrointestinal stromal tumours ( GISTs ) with negative CD117. Methods : Sixteen cases of GISTs with negative CD117 were investigated by HE staining, EnVision immunostaining and electron microscopy. Results : Eleven patients were male and five were female,32 -67 years in age ( mean 54 years ). Nine patients were followed up and one dead. GISTs tend to fall into three categories of morphology, spindle cell, epithelioid or mixed. Immunohistochemically , the tumors were positive for DOGI 81. 2％( 13/16 ),CD117 0％( 0/16 ),CD34 63％( 10/16 ), Des 6％( 1/16 ),α - SMA 31.3％( 5/16 ) and S -100 12.5％( 2/16 ). The ultrastructural feature of one case was similar to those of the interstitial cell of Cajal (ICC ). Conclusion : GISTs with negative CD117 could he diagnosed hy immunohistochemistry for DOG1 and ultrastructural findings.