摘要目的 检测胃肠道间质瘤(GIST)组织中CD133及CD44表达情况及其对预后的影响.方法 采用免疫组化SP法检测42例GIST中CD133及CD44蛋白表达,并对其临床病理指标相关性进行分析.结果 GIST中CD133及CD44蛋白的阳性表达率分别为21.4％(9/42)、78.6％(33/42),且CD133及CD44蛋白阳性表达与肿瘤大小、核分裂数有关(P＜0.05).生存分析显示,CD133阳性组患者的存活时间(23.2个月)明显短于阳性患者(63.1个月)(P＜0.05),且CD44阴性组患者的存活时间(23.2个月)显著短于阴性患者(63.3个月)(P＜0.05).单因素分析表明GIST预后不佳因素包括肿瘤大小(≥5 cm)、核分裂数(≥5/HP)及CD133阳性表达和CD44阴性表达.多因素分析显示肿瘤大小、核分裂数和CD44表达(回归系数为-1.410、Wald统计量为4.749、P ＜0.05)是影响GIST预后的独立因素.结论 CD133阳性表达与CD44阴性表达可作为GIST临床评价肿瘤生物学行为及评估预后的指标.

abstractsObjective To investigate the expressions of CD133 and CD44 and their prognostic significance in gastrointestinal stromal tumors (GIST).Methods Streptavidin perosidase (SP) method of immunohistochemistry was used to detect expressions of CD133 and CD44 proteins in 42 cases of GIST, and the relationship between their expressions and tumor size, mitotic count were analyzed by univariate and multivariate factor analyses.Results The expressions of CD133 and CD44 proteins in GIST were 21.4％ (9/42) and 78.6％ (33/42), respectively.The expressions of CD133 and CD44 proteins were significantly correlated with tumor size and mitotic count (P ＜ 0.05).Univariate factor analysis showed that the overall survival of GIST patients with positive CD133 protein (23.2 months) was shorter than that of patients with negative CD133 protein(63.1 months) (P ＜ 0.05).The overall survival of GIST patients with negative CD44 protein (23.2 months) was shorter than that of patients with positive CD44 protein (63.3 months) (P ＜ 0.05).Multivariate factor analysis showed that tumor size, mitotic count and CD44 protein were independent prognostic indicators for survival time after operation.Conclusions The positive expressions of CD133 and CD44 proteins might be the prognostic factors of GIST patients.