Dept of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Am J Clin Pathol. 2011 Mar;135(3):448-53. doi: 10.1309/AJCP0PPKOBNDT9LB.
Initial diagnosis of submucosal gastrointestinal stromal tumors (GISTs) is often made from material obtained by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Although 95% of GISTs are positive for KIT by immunohistochemical analysis on surgical specimens, we have observed several cases of GIST that were negative for KIT on the cell block but subsequently positive on the surgical resection. DOG1 has been found to be a specific and sensitive marker for GISTs on surgical material. We compared KIT and DOG1 staining in 52 GIST cell blocks and in 44 cell blocks of other intra-abdominal spindle cell neoplasms. We found that DOG1 was the more sensitive marker, with positivity in all 52 GIST cell blocks. KIT was positive in 46 (88%) of the GIST cases, with sensitivity dependent on the FNA method. Both markers were highly specific: KIT was negative in all 44 non-GIST cases, whereas DOG1 showed weak positivity in only 1 leiomyosarcoma.
黏膜下胃肠道间质瘤(GIST)的初步诊断通常是通过内镜超声引导下细针抽吸(EUS-FNA)获得的材料进行的。虽然 95%的 GIST 在手术标本的免疫组织化学分析中 KIT 阳性,但我们已经观察到一些 GIST 在细胞块上 KIT 阴性,但随后在手术切除中阳性。DOG1 已被发现是手术标本中 GIST 的特异性和敏感性标志物。我们比较了 52 个 GIST 细胞块和 44 个其他腹腔内梭形细胞肿瘤的细胞块中的 KIT 和 DOG1 染色。我们发现 DOG1 是更敏感的标志物,在所有 52 个 GIST 细胞块中均为阳性。KIT 在 46 例(88%)GIST 病例中为阳性,其敏感性取决于 FNA 方法。两种标志物均具有高度特异性:KIT 在所有 44 例非 GIST 病例中均为阴性,而 DOG1 在仅 1 例平滑肌肉瘤中显示弱阳性。