Mersin University, Medical School, Department of Pathology, Turkey.
Pathol Res Pract. 2013 Jul;209(7):413-7. doi: 10.1016/j.prp.2013.04.005. Epub 2013 Apr 30.
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract, and the majority contain KIT or PDGFRA-activating mutations. However, up to 10% of GISTs are c-kit-negative. Antibodies with increased sensitivity and specificity for the detection of c-kit-negative GIST cases may be of value, especially because some of these cases may also benefit from tyrosine kinase inhibitor therapy. Hematoxylin and Eosin sections of 33 GISTs were re-examined in order to define histopathological criteria used in risk assessment of these tumors. Immunohistochemistry with a panel of antibodies [c-kit, DOG1 (discovered on GIST 1), CD34, smooth muscle actin (SMA), Desmin, S100 and Ki67] was performed on 5μm-thick paraffin sections of all tumors. Statistical analysis of immunohistochemical studies showed that DOG1 and CD117 were the most sensitive and specific antibodies in the diagnosis of GISTs. Other antibodies were unhelpful in confirming a diagnosis of GIST, but were particularly useful in the differential diagnosis. Reactivity for DOG1 may aid in the diagnosis of GISTs, which fail to express c-kit antigen, and lead to appropriate treatment with imatinib mesylate, an inhibitor of the KIT tyrosine kinase.
胃肠道间质瘤（GIST）是胃肠道最常见的间叶性肿瘤，大多数含有 KIT 或 PDGFRA 激活突变。然而，高达 10%的 GIST 是 c-kit 阴性的。对于检测 c-kit 阴性 GIST 病例具有更高敏感性和特异性的抗体可能具有价值，特别是因为其中一些病例也可能受益于酪氨酸激酶抑制剂治疗。为了定义这些肿瘤风险评估中使用的组织病理学标准，重新检查了 33 例 GIST 的苏木精和伊红切片。对所有肿瘤的 5μm 厚石蜡切片进行了一组抗体[c-kit、DOG1（GIST1 发现）、CD34、平滑肌肌动蛋白（SMA）、结蛋白、S100 和 Ki67]的免疫组织化学染色。免疫组织化学研究的统计分析表明，DOG1 和 CD117 是诊断 GIST 最敏感和最特异的抗体。其他抗体无助于确认 GIST 的诊断，但在鉴别诊断中特别有用。DOG1 的反应性可能有助于诊断未能表达 c-kit 抗原的 GIST，并导致使用伊马替尼治疗，伊马替尼是 KIT 酪氨酸激酶的抑制剂。
