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目的检测胃肠道间质瘤(GIST)组织中DOG-1、蛋白激酶C(PKC)-θ的表达情况及CD105标记的微血管密度(MVD),并探讨其临床意义。方法采用免疫组化法检测DOG-1、PKC-θ及CD105在86例GIST、30例非GIST间叶组织肿瘤及20例对照胃组织中的表达情况并计数MVD值,分析其与GIST临床病理指标的关系。结果①86例GIST组织中CD117、DOG-1、PKC-θ的阳性表达率分别为84.9%、93.0%、89.5%,其中DOG-1、PKC-θ在CD117阴性组的表达率分别为61.5%、69.2%,而在非GIST间叶组织肿瘤中DOG-1不表达,PKC-θ表达率为3.3%,对照胃组织中未见阳性表达。CD105标记的MVD值在GIST组织和对照胃组织分别为(6.23±1.72)、(3.56±1.13),差异有统计学意义(P<0.01);②DOG-1与肿瘤的核分裂像、危险度分级呈负相关(P<0.05),PKC-θ与肿瘤的危险度分级呈正相关(P<0.05),MVD值与肿瘤的直径、核分裂像及危险度分级呈正相关(P<0.05),高MVD组与低MVD组术后1、3、5年生存率分别为92.9%、73.8%、45.7%和100%、93.1%、77.9%,差异有统计学意义(P<0.01)。DOG-1、PKC-θ阳性组与阴性组术后生存率比较,差异无统计学意义。结论 DOG-1、PKC-θ是GIST敏感且特异性的诊断标记物,特别对于CD117阴性表达GIST有重要诊断意义。DOG-1、PKC-θ表达与GIST预后无关,CD105标记的MVD值与GIST预后有关。
Objective To detect the expression of DOG-1, PKC-θ and the expression of CD105-labeled microvessel density (MVD) in gastrointestinal stromal tumors (GISTs) and to investigate its clinical significance. Methods Immunohistochemistry was used to detect the expression of DOG-1, PKC-θ and CD105 in 86 cases of GIST, 30 cases of non-GIST mesenchymal tumor and 20 cases of control gastric tissue. The MVD values were counted and analyzed with clinicopathological features of GIST The relationship between indicators. Results ① The positive expression rates of CD117, DOG-1 and PKC-θ in 84 cases of GIST were 84.9%, 93.0% and 89.5%, respectively. The expression rates of DOG-1 and PKC-θ in CD117 negative group were 61.5% 69.2%. However, DOG-1 was not expressed in non-GIST mesenchymal tumors. The expression rate of PKC-theta was 3.3%, but no positive expression was found in the control gastric tissues. The MVD value of CD105 was (6.23 ± 1.72) and (3.56 ± 1.13) respectively in GIST and control groups (P <0.01). ②DOG-1 was associated with tumor mitochondria, risk grade (P <0.05). There was a positive correlation between PKC-θ and tumor risk grade (P <0.05), MVD value was positively correlated with tumor diameter, mitosis and risk grade (P <0.05) The 1, 3, 5 year survival rates of low MVD group were 92.9%, 73.8%, 45.7% and 100%, 93.1% and 77.9%, respectively, with significant difference (P <0.01). DOG-1, PKC-theta positive group and negative group postoperative survival rate, the difference was not statistically significant. Conclusions DOG-1 and PKC-θ are sensitive and specific diagnostic markers for GIST, especially for CD117 negative expression of GIST. The expression of DOG-1 and PKC-θ had no correlation with the prognosis of GIST. The MVD of CD105 markedly correlated with the prognosis of GIST.