胃肠道间质瘤36例临床病理分析 (pdf)

    【摘要】 目的 探讨胃肠道间质瘤(GIST)的临床病理特点。方法 对36例GIST的病例进行分析，并对其进行CD34、CD117、Vimenti、Desmin、Actin、S-100共6种免疫组化分析。结果 肿瘤的发生部位：胃15例(54%)，小肠11例(39.6%)，其他部位10例(36%)。肿瘤直径0.5～20cm(平均6.5cm)。肿瘤最大直径≥5cm，核分裂相数≥5/50HPF及有溃疡形成3项在良性与恶性之间有显著意义。免疫组化的阳性表达结果为：11例恶性及潜在恶性GIST中CD34、CD117、Vimenti蛋白阳性表达分别为9例(81.8%)、10例(90.9%)、11例(100%)，Desmin(-)、Actin(-)、S-100(+)表达分别为10例(90.9%)、11例(100%)、9例(81.8%)。结论 肿瘤的大小是胃肠道间质瘤良、恶性的重要指标，GIST具有独特的免疫组化表型，是有别于平滑肌肿瘤的一类成分复杂的间叶性肿瘤。

    【关键词】 胃肠肿瘤；间质瘤；病理；临床；免疫组织化学

    A clinicopathologic and immunohistochemical study on 36 cases of gastrointestinal stromal tumor (GIST)

    CHENG Ling,HU Zhi-hong,WU Ping,et al.

    Department of Pathology,Jiujiang Medical College,332000 China

    【Abstract】 Objective To investigate the clinicopathologic features of GIST.Methods Thirty-six GIST cases were collected and studied by Immunohistochemical assays of CD34、CD117、Vimenti、Desmin、Actin、S-100.Results 42%(15/36) of the tumors located in the stomach,30%(11/36) in the small intestine,28%(10/36) in the others.Tumors varied greatly in size,ranging from 0.5 to 20cm (average 6.5cm),morphologic criteria of malignancy are tumor size ≥5cm,mitotic rates ≥5/50 HPF and ulcer formation and there were significant differences between the benign and the malignant. Immunohistochemical staining results:CD34 positive in 9 cases (90%),CD117 in 10cases (99%),Vimenti in 11 cases (100%);Desmin negative in 10 cases (99%),Actin in 11 cases (100%), S-100 in 9 cases (90%).Conclusion GIST occur predominantly in Meddle-aged and older persons.The main criteria of malignancy of GIST are tumor size ≥5cm,mitotic rates ≥5/50 HPF and ulcer formation.Immunohistochemical study is very important to distinguish GIST. ......