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目的探讨nestin在胃肠道间质瘤(gastrointestinal stromal tumors,GISTs)辅助诊断中的价值。方法用免疫组化EnVi-sion法检测96例CD117阳性、5例CD117阴性的GISTs,以及食管平滑肌瘤(10例)、消化道雪旺瘤(33例)、肠纤维瘤病(6例)以及腹腔平滑肌肉瘤(15例),观察这些肿瘤中nestin的表达状况。结果96例CD117阳性的GISTs中,94例表达nestin,其中70例弥漫强表达,21例中度阳性,3例局灶阳性,仅2例阴性;5例CD117阴性的GISTs中,4例表达nestin;33例消化道雪旺瘤中26例表达nestin;15例平滑肌肉瘤中3例局灶表达nestin;10例食管平滑肌瘤、6例肠纤维瘤病均为阴性。结论nestin是辅助诊断GISTs的新指标,可鉴别GISTs与平滑肌肿瘤和纤维瘤病,但在GISTs与雪旺瘤的鉴别中需结合S-100蛋白等指标。
Objective To investigate the value of nestin in the diagnosis of gastrointestinal stromal tumors (GISTs). Methods 96 cases of CD117 positive, 5 cases of CD117 negative GISTs and 10 cases of esophageal leiomyoma (10 cases), gastrointestinal Schwannoma (33 cases), enteric fibromatosis (6 cases) were detected by immunohistochemical EnVi-sion method. And peritoneal leiomyosarcoma (15 cases), the expression of nestin in these tumors was observed. Results Ninety-four of 96 CD117-positive GISTs expressed nestin, of which 70 were diffusely and strongly expressed, 21 were moderately positive, 3 were focal and only 2 were negative. Among the 5 CD117-negative GISTs, 4 showed nestin ; Nestin was expressed in 26 cases of 33 cases of gastrointestinal Schwannoma; nestin was expressed in 3 cases of 15 cases of leiomyosarcoma; 10 cases of esophageal leiomyoma and 6 cases of enteric fibromatosis were all negative. Conclusion Nestin is a new index for the diagnosis of GISTs. It can distinguish GISTs from smooth muscle tumors and fibromatosis. However, nestin-S protein and other markers need to be integrated in the identification of GISTs and Schwannoma.