Expression Of Immunophenotype In Gastrointestinal Stromal Tumors And The Clinical Significance

Gastrointestinal stromal tumors(GIST) being diagnosed to beliomyoma(liomyosarcoma) or schwannoma(maglignant) for a longtime,is the most common mesenchymal tumors of the gastrointestinaltract tumor. Because of the complex and varied biological behavior, theproperty of GIST is hard to defined.Though riskstratify is widely usedto judge the prognosis and guide molecular targeted therapy,the biologicalbehavior cannot be accurately evaluted.Recurrence and metastasis canremain dormant for years in some cases in low risk of recurrence aftercomplete resection surgery. Immunophenotype is significant as theroutine examination in the diagnosis of GIST, with the feature ofconvenient detection and quantification. If the existing indexes can beused to diagnose risk degree and guide expensive post-operationtreatment reasonably, it will be of important diagnositic significance.Objective To analyse the expression and diagnositic significanceof immunophenotype in gastrointestinal stromal tumors, to discuss therelationship of risk degree and prognosis with the immunophenotype, toprovide the theory evidence for improving the diagnosis,discriminatingthe prognosis and guiding post-operation treatment. Methods Sixty-five patients,diagnosed as GIST (Gastrointestinalstromal tumors)post-operation in First Hospital of Jilin University fromDecember2008to August2012,was analyzed retrospectively.Theexpression of CD117, CD34, DOG1, SMA,S-100,Ki67and Desmin weretested by immunohistochemical S-P method. To discuss the relationshipbetween the immunophenotype and clinical athology,prognosis,the dataswere analyzed by SPSS17.0software.Results1. The positive rate of DOG1，CD117，CD34,SMA,S-100and Desmin was100%，96.9%，89.2%,29.2%,6.2%and4.6%respectivelyin GIST.2. The positive rate of CD34in stomach is higher than that insmall intestine(P<0.05),while the positive rate of SMA in small intestine ishigher than that in stomach (P<0.05).The expressions of CD117, DOG1,S-100, Desmin, CD34and SMA had no statistic difference in differentsites.3. The expression of Ki67was positively correlated with the riskdegree and mitosis count.4. Multivariate analysis showed that theexpression of Ki67was positively correlated with tumor size,risk degreeand mitosis count.5. The mortality rate of Ki67-positive group was higherthan that of Ki67-negative group in follow-up.6. The recurrence rate andmortality rate in oral drug group had no difference with that inextra-low-risk and low-risk groups.Conclusions1. CD117which maybe a specific index in thediagnosis of GIST,was positive expressed in most of GIST cases.Combined with CD34and DOG1can improve the diagnosticrate.S-100,SMA and Desmin was rarely expressed,the focal expressions ofwhich can distinguish from neurogenic tumor and smooth muscle tumor.2.The expression of CD34in stomach is higher than that in smallintestine,while the expression of SMA in small intestine is higher than thatin stomach.3. The expression of Ki67was positively correlated with tumorsize,risk degree and mitosis count and furthermore was positivelycorrelated with recurrence rate and mortality rate. Ki67maybe anindicator in the diagnosis of GIST.