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目的:利用组织芯片技术和免疫组化方法相结合探讨胃肠道间质瘤的病理特点及免疫表型特征,阐明其诊断和鉴别诊断的要点。方法:利用80点胃肠道间质瘤芯片以免疫组织化学S-P法对上述组织进行CD117、CD34、SMA、Desmin、Vimentin、NSE、S-100及Syn检测并分析其病理特点。同时以60点胃肠道平滑肌瘤与神经鞘瘤复合组织芯片作对比分析。结果:胃肠道间质瘤、平滑肌瘤、神经鞘瘤组织学上均以梭形细胞为主,恶性者出现明显异形性,伴多少不等出血、坏死、粘液变等。免疫组化染色胃肠道间质瘤CD117、CD34表达率分别为95.0%、84.3%,弥漫强阳性表达。平滑肌瘤CD117和CD34表达率分别为11.1%和20.0%,与胃肠道间质瘤组表达率差异具有显著性。神经鞘瘤中1例良性神经鞘瘤出现CD117表达,CD34未见表达。结论胃肠道间质瘤中CD117和CD34呈高表达,是其敏感的标记物,部分可伴有肌源性标记物或神经源性标记物表达。组织芯片技术具有高通量大样本的特点,为筛选肿瘤的免疫学标记物提供了一个很好的平台。
OBJECTIVE: To explore the pathological features and immunophenotypic features of gastrointestinal stromal tumors by tissue microarray and immunohistochemistry, and to clarify the main points of diagnosis and differential diagnosis. Methods: The pathological features of CD117, CD34, SMA, Desmin, Vimentin, NSE, S-100 and Syn were detected by immunohistochemical S-P method in 80 gastrointestinal stromal tumors. At the same time 60 gastrointestinal leiomyoma and schwannoma composite tissue chip for comparative analysis. Results: Gastrointestinal stromal tumors, leiomyomas and schwannomas were mainly spindle-shaped cells. Malignant patients showed obvious heteromorphism with varying degrees of hemorrhage, necrosis and mucus changes. Immunohistochemical staining of gastrointestinal stromal tumors CD117, CD34 expression rates were 95.0%, 84.3%, diffuse strongly positive expression. Expressions of leptin and CD34 in leiomyoma were 11.1% and 20.0%, respectively, which were significantly different from those in gastrointestinal stromal tumors. One case of schwannoma in schwannomas showed CD117 expression but no expression of CD34. Conclusion The high expression of CD117 and CD34 in gastrointestinal stromal tumors is a sensitive marker, and some may be associated with the expression of myogenic or neurogenic markers. Tissue chip technology has the characteristics of high-throughput large samples for the screening of tumor immunological markers provides a good platform.