Gastrointestinal stromal tumours: Correlation of immunophenotype with clinicopathological features
Gastrointestinal stromal tumours: Correlation of immunophenotype with clinicopathological features
复制标题
胃肠道间质肿瘤：免疫表型与临床病理特征的相关性
作者：
P. Newman;Catherine Wadden;C. Fletcher
胃肠道间质瘤仍然是一个长期存在争议的来源，因为它们被提议的分化路线和预测它们的生物学行为的难度。我们用一组七种抗体检查了60例，以识别平滑的肌肉或神经分化。在我们的手中，36%的病例表现为神经分化(尽管只有6.6%的病例表达S-100蛋白)，31%的病例表现为光滑的肌肉组织，20%的病例表现为双向分化，13%的病例所有标志物均为阴性。组织学表现不能可靠地反映免疫表型。我们试图将免疫表型与病变部位及其临床行为联系起来。42例平均随访5年。具有神经表型的肿瘤预后最好。同时表达结蛋白和平滑肌肌动蛋白的胃肿瘤(在没有其他标记物的情况下)每30hpf最多有4个有丝分裂，表现为良性。需要更大规模的研究来证实免疫表型对这一复杂肿瘤组的价值。
Stromal tumours of the gastrointestinal tract remain a persistent source of controversy with regard to both their proposed lines of differentiation and the difficulty in predicting their biological behaviour. We have examined 60 cases with a panel of seven antibodies directed at the identification of smooth muscular or neural differentiation. In our hands, 36 per cent of cases showed neural differentiation (although only 6.6 per cent expressed S‐100 protein); 31 per cent appeared smooth muscular; 20 per cent manifested bidirectional differentiation; and 13 per cent were negative for all the markers used. Histological appearances do not reliably reflect immunophenotype. We have attempted to correlate immunophenotype with the site of the lesions and with their clinical behaviour. Mean follow‐up of 5 years was obtained in 42 cases. Tumours with a neural phenotype have the best prognosis. Gastric tumours expressing both desmin and smooth muscle actin (in the absence of other markers) with up to 4 mitoses per 30 HPF behave in a benign fashion. Larger studies are required to substantiate the value of immunophenotyping this complex group of tumours.