摘要
目的:探讨胃肠道间质瘤(GIST)的临床病理和免疫组化特点．方法:回顾性分析我院收治的24例GIST患者的临床病理及随访资料,并对其石蜡标本采用免疫组化SP染色法检测,分析其免疫组化特点．结果:本组GIST发病年龄29—75(平均54．5±13．5),男16例,女8例,主要发生在胃、小肠、直肠．并多以腹部隐痛不适、腹部肿物、上消化道出血为首发症状,全部患者进行积极外科治疗,肿瘤切除率100％,术后复发转移率为14．3％．大多数病例为手术切除后确诊．肿瘤大小从2-16 cm(平均6．6±3．9 cm)．基本病理组织形态为梭形细胞型,上皮细胞型较少．5例核分裂像>5／50HPF者其肿瘤直径均>5 cm,其中4例伴有囊性变、出血或坏死．4例核分裂像为2-5／50HPF者肿瘤直径在3-5 cm之间．免疫组化染色CD117,CD34,Vim为弥漫强阳性,阳性率分别为91．7％,62．5％和66．7％．S-100阴性, SMA呈灶状阳性．结论:GIST好发于中老年,缺乏特异的临床表现,早期诊断困难,外科手术仍是未转移的GIST的首要治疗方式,并且其肿瘤细胞形态多变,排列方式多样,免疫组化染色为CD117, CD34和Vim阳性,S-100阴性,SMA呈灶状阳性．
AIM：To explore the histopathological and immunohistochemical features of gastrointestinal stromal tumors （GIST）.METHODS： Immunohistochemistry was performed in GIST, for a panel of antibodies such as CD117, CD34, Vim, SMA, S-100 by SP staining methods. Clinical data and follow-up documents of 24 patients with GIST admitted from January 2000 to May 2006 were studied retrospectively. RESULTS： There were 24 patients （males and 8 females） aged from 29 to 75 （mean 54.5 ± 13.5）. The tumors were mainly located at the stomach, small bowel and rectum. The initial presentations were bellyache （33.3%）, abdomen mass （25.0%） and gastrointestinal bleeding （20.8%） in the most cases. All patients received successful surgical resection of tumor and the total resection rate was 100%. The rate of recurrence and metastasis was 14.3% （3/21） after operation. The most cases were diagnosed after surgical resection. Tumor size varied from 2 to 16 cm （mean 6.6 am）. The cells were spindle-like, and the epithelioid cells were rare. The mitotic count was higher than 5/50HPF in 5 cases, in which the tumor sizes were over or equal to 5 cm in diameter, and cystification, hemorrhage or necrosis was observed in 4 cases. The mitotic count was 2-5/50HPF in 4 cases, in which the tumor sizes were 3-5 cm in diameter. Immunohistochemically, CD117, CD34 and Vim showed diffuse and strong expression, and the positive rates were 91.7%, 62.5% and 66.7%, respectively. S-100 was hardly present, and SMA was focally present or absent. CONCLUSION： GIST predominantly occurs in the middle aged or old patients without specific manifestations, so early diagnosis is fairly difficult. Surgery remains the standard treatment for non-metastasis patients with GIST. The tumor cells have various kinds of types and different arrangements. Immunohistochemical staining is positive for CD117, CD34 and Vim, negative for S-100, and focal positive for SMA.
出处
《世界华人消化杂志》
CAS
北大核心
2006年第22期2241-2246,共6页
World Chinese Journal of Digestology
关键词
胃肠道间质瘤
临床病理
免疫组化
Gastrointestinal stromal tumors
Histopathology
Immunohistochemistry
