The Immunohistochemical Study On 68 Cases Gastrointestinal Stromal Tumors

Objective: Through the examination of immunohistochemical features of gastrointestinal stromal tumors(GISTs), to further discuss the cellular origin and differentiation, investigate the best immunohistochemical diagnosis combination markers of GISTs, seek the probable diagnosis marker in non- CD117 positive expression GISTs.Methods: 68 cases of gastrointestinal stromal tumors were obtained from the archives in the Department of Pathology of Wuhan University Zhongnan Hospital from 1995 to 2003. All cases were marked with an immunohistochemistry panel including CD117(c-kit), CD34, a-SMA, NSE, nestin, HCD, PCNA, Bcl-2, PDGFRA , and then to stastical analyse the correlation between the expression of each marker and pathological parameters.Results: (1) The positive rates of 68 GISTs samples for CD117, CD34, nestin, HCD protein were 94.12% (64/68) ,75% (51/68) ,97.00 % (66/68), 77.94%(53/68) respectively. No correlation was observed between the expression of CD117, CD34, HCD protein with pathologic parameters (P>0.05).The expression of nestin protein was associated with the histological type(P<0.05). (2)The relevance between CD117, CD34 and nestin, HCD protein expression had no statistic significance (P>0.05). According to CD117, CD34 protein expression grouping, nestin and HCD protein had strong coexpression in each group obviously. (3) Significant correlation was observed between PCNA average grey with the risk of aggressive behavior(P<0.05),but not observed of Bcl-2 (P>0.05). (4) Among 64 GISTs which CD117 protein was positive expression, PDGFRA protein had not seen positive expression case, but there was one PDGFRA positive expression case in 4 non-CD117 positive expression GISTs.Conclusions: â‘  The high positive rate of nestin and HCD in the GISTs further supports that GISTs originate from multi-potential stem cells. In the most GISTs cases,the tumor cells can show the immunity phenotype of myo-source and nerve-source simultaneously. (2) In the diagnose of GISTs, the union of CD117* CD34* nestinand HCD is the best immunohistochemical combination plan. (3) The unbalance of the cell proliferation and apoptosis is one of the important mechanisms in the differentiation degree of GISTs. PCNA examination is helpful to judge the risk of aggeressive behavior of GISTs, but Bcl-2 protein isn't. ? The examination of PDGFRA protein may be useful in the diagnose of the non-CD117 protein positive expression GISTs, also may further provide the basis for the clinical treatment of GISTs.