CD117、CD34、DOG-1在胃肠道间质瘤中的表达及预后分析

发布时间：2019-04-21 21:40

【摘要】：目的:通过评价CD117、CD34和DOG-1等在胃肠道间质瘤中的表达,来分析这些表达的蛋白对肿瘤的特异性识别和对高危患者的生存率预测的影响。方法:回顾性分析皖南医学院第一附属医院2011年8月-2015年9月以来经过病理证实的胃肠间质瘤病人133例,并应用免疫组化的方法检测GISTs患者中CD117、CD34和DOG-1等相关标记物的表达,采用SPSS19.0软件分析上述免疫组织化学指标与临床病理因素(部位、肿瘤大小、核分裂象、组织学类型和危险度)的相关性.结果:其中男性患者70例,女性患者63例,比例为1:0.9。发病时间为2天-数月不等。患者发病年龄最小为41岁,年龄最大为86岁,中位发病年龄64岁,年龄与CD117、CD34、DOG-1之间并无统计学意义(P0.05)。本研究中间质瘤位于胃的占80例(60.15%),其次是小肠37例(27.81%),结直肠为13例(9.77%),最后腹腔或系膜部位3例(2.25%)。其中镜下组织细胞分型中梭形细胞为主型86例,上皮样细胞为主型25例,混合型22例;免疫组化CD117阳性率96.24%(128/133)、CD34阳性率90.2%(120/133)、DOG-1阳性率90.2%(120/133)。133例患者随访17个月~69个月,失访34例,肿瘤复发25例,其他死亡原因者14例,余60例患者一般情况良好。根据美国国立卫生研究院(NIH)确定的GIST危险度分级(2008年)进行恶性度分级(表2)后,极低危26例(20%)、低危38例(29%)、中危27例(20%)和高危42例(31%)。133例患者随访17-69个月,失访34例,肿瘤复发25例,其他死亡原因者14例,余60例患者一般情况良好。DOG-1蛋白的表达与肿瘤的组织学类型之间的关系有显著性差异(P=0.005),CD34的表达与肿瘤的位置之间的关系有显著性差异(P=0.026)。在生存率曲线中,CD117、CD34和DOG均无统计学意义(P0.05),但DOG-1阳性表达(P=0.096)患者有更长的生存时间。结论:CD117、CD34和DOG可以相互补充提高GIST患者诊断率。肿瘤的形态学特征对预测间质瘤病人的生存时间有着很大的关联性,对每一种情况都进行深入分析对预测患者的生存期起着关键性作用,这可能为其以后的治疗提供帮助。
[Abstract]:Aim: to evaluate the expression of CD117,CD34 and DOG-1 in gastrointestinal stromal tumors (GIST) in order to analyze the effects of these expressed proteins on tumor specific recognition and survival rate prediction in high risk patients. Methods: from August 2011 to September 2015 in the first affiliated Hospital of Southern Anhui Medical College, 133 cases of gastrointestinal stromal tumor confirmed by pathology were analyzed retrospectively. The immunohistochemical method was used to detect CD117, in patients with GISTs. The expression of CD34, DOG-1 and other related markers were analyzed by SPSS19.0 software. The correlation between the above immunohistochemical indexes and clinicopathological factors (location, tumor size, nuclear splitting image, histological type and risk) was analyzed. Results: among them, 70 cases were male and 63 cases were female, the proportion was 1. 9%. The onset time is 2 days-several months do not wait. The onset age was 41 years and 86 years respectively. The median age of onset was 64 years. There was no significant difference between the age and CD117,CD34,DOG-1 (P0.05). In this study, 80 cases (60.15%) were located in the stomach, 37 cases (27.81%) in the small intestine, 13 cases (9.77%) in the colorectal, and 3 cases (2.25%) in the final abdominal or mesenteric region. Among them, 86 cases were spindle type, 25 cases were epithelioid type and 22 cases were mixed type. The positive rates of CD117, CD34 and DOG-1 were 96.24% (128 / 133), 90.2% (120 / 133), 90.2% (120 / 133) and 90.2% (120 / 133) respectively. Other causes of death were found in 14 cases, and the remaining 60 cases were generally in good condition. According to the GIST risk rating (2008) determined by the National Institutes of Health (NIH), 26 cases (20%) were extremely low-risk and 38 cases (29%) were low-risk, according to the grade of malignancy (Table 2) determined by the National Institutes of Health (NIH). There were 27 cases (20%) at middle risk and 42 cases (31%) at high risk. 133 cases were followed up for 17 months, 34 cases lost follow-up, 25 cases suffered recurrence of tumor and 14 cases died of other causes of death. There was a significant difference between the expression of dog-1 protein and the histological type of the tumor (P < 0. 005), and a significant difference between the expression of CD34 and the location of the tumor (P < 0. 026), and there was a significant difference between the expression of DOG-1 protein and the histological type of the tumor (P < 0. 005). In the survival curve, there was no significant difference between CD117,CD34 and DOG (P0.05), but the patients with positive expression of DOG-1 (P0. 096) had longer survival time. Conclusion: CD117,CD34 and DOG can complement each other to improve the diagnostic rate of GIST. The morphological features of tumors have a great correlation in predicting the survival time of patients with stromal tumors. The in-depth analysis of each case plays a key role in predicting the survival time of the patients, which may be helpful for future treatment.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735

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