Muscle Differentiation and Clinicopathologic Features of Gastrointestinal Stromal Tumors
Muscle Differentiation and Clinicopathologic Features of Gastrointestinal Stromal Tumors
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胃肠道间质瘤的肌肉分化和临床病理特征
DOI：
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发表时间：
1992
影响因子：
5.6
通讯作者：
H. Frierson
中科院分区：
文献类型：
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作者：
D. Franquemont;H. Frierson
我们分析了46例胃肠道间质瘤（gist），使用一组抗体来确定平滑肌分化的频率以及免疫表型与组织病理学特征和临床行为的关系。仅根据临床行为将36例胃肠道间质瘤分类为良性或恶性；良性病变至少需要2年的随访。gist免疫阳性的分类如下：46例中的vimentin 45、45例中的desmin 9、46例中的肌肉特异性肌动蛋白（MSA） 36、46例中的α -平滑肌肌动蛋白（SMA） 34、38例中的鸡砂囊肌动蛋白-7 0、46例中的细胞角蛋白2、46例中的SI00蛋白6、46例中的胶质纤维酸性蛋白（GFAP） 0、46例中的突触素0和46例中的嗜色粒蛋白1。46例肿瘤中有39例至少有一种肌肉标志物呈阳性。其中MSA阳性/SMA阴性5例，MSA阴性/SMA阳性3例。所有desmin阳性病例均与MSA或SMA反应。8名gist阳性vimentin， MSA， SMA和desmin，而7名仅vimentin阳性。与后者相比，前者更小，更少坏死，临床良性（p<0.05）。仅vimentin阳性的gist均为恶性。免疫组织化学特征与肿瘤部位、细胞结构、核多形性或有丝分裂率无关。良性胃肠道间质瘤的细胞数量少于恶性胃肠道间质瘤（p<0.05），但在核多形性程度、坏死程度、有丝分裂率和大小方面无统计学差异。我们得出结论：(a) 85%的gist至少与一种肌肉抗体发生反应；(b)免疫组化特征与解剖部位无关；(c) SMA实际上与MSA一样敏感，而desmin则不那么敏感；(d) vimentin、MSA、SMA和desmin同时呈阳性与良性预后相关。
We analyzed 46 gastrointestinal stromal tumors (GISTs) using a panel of antibodies to determine the frequency of smooth muscle differentiation and the relationship of immunophenotype to histopathologic features and clinical behavior. Thirty-six GISTs were classified as benign or malignant based exclusively on clinical behavior; a 2-year minimum follow-up was required for benign lesions. GISTs were immunopositive in the following categories: vimentin 45 of 46, desmin nine of 45, muscle-specific actin (MSA) 36 of 46, α -smooth muscle actin (SMA) 34 of 46, chicken gizzard actin-7 zero of 38, cytokeratin two of 46, SI00 protein six of 46, glial fibrillary acidic protein (GFAP) zero of 46, synaptophysin zero of 46, and chromogranin one of 46. At least one muscle marker was positive in 39 of 46 tumors. Five GISTs were MSA positive/ SMA negative, and three were MSA negative/SMA positive. All desmin-positive cases reacted with MSA or SMA. Eight GISTs were positive for vimentin, MSA, SMA, and desmin, whereas seven were vimentin positive only. Compared with the latter, the former tended to be smaller, less often necrotic, and clinically benign (p<0.05 for each). All vimentin-positive only GISTs were malignant. Immunohistochemical features did not correlate with tumor site, cellularity, nuclear pleomorphism, or mitotic rate. Benign GISTs were less cellular than were malignant GISTs (p<0.05), but they did not differ statistically in degree of nuclear pleomorphism, necrosis, mitotic rate, or size. We conclude that (a) 85% of GISTs react with at least one muscle antibody; (b) immunohistochemical features are unrelated to anatomic site; (c) SMA is, in effect, as sensitive as MSA, whereas desmin is less sensitive; and (d) simultaneous vimentin, MSA, SMA, and desmin positivity correlates with a benign outcome.