摘要
目的探讨伴有转移的胃肠道间质瘤(gastrointestinal stromal tumors,GIST)临床病理特征及其淋巴结转移的机制。方法收集45例伴有转移的GIST并选取同期50例原发GIST作对比分析。采用免疫组化En Vision法染色标记Ki-67、CD31、D2-40,计数微血管密度(micro vessel density,MVD)和微淋巴管密度(lymphatic microvessel density,LMVD)。结果 GIST总转移率为5.45%,血道转移率为1.33%,淋巴结转移率为1.09%。转移性GIST实质内的MVD为每平方毫米398.39±68.20个,非转移性GIST实质内的MVD为每平方毫米192.07±56.85个,两者差异有统计学意义。转移性及非转移性GIST实质内均无淋巴管,转移性GIST边缘区LMVD为每平方毫米13.28±2.40个、周围正常组织LMVD为每平方毫米25.36±6.71个;非转移性GIST边缘区LMVD为每平方毫米12.21±1.83个、周围正常组织LMVD为每平方毫米24.23±8.64个;两组GIST边缘区及周围正常组织内LMVD差异无统计学意义。GIST形态学观察可见淋巴结转移组9例均呈浸润性生长,而非淋巴结转移组仅12例(12/86)呈浸润性生长。结论转移性GIST的MVD高于非转移性GIST,GIST肿瘤实质内无淋巴管,肿瘤呈浸润性生长可能是淋巴结转移的原因。
Purpose To explore the clinicopathologic features of metastatic gastrointestinal stromal tumors （GIST） and the mechanism of lymph node metastasis. Methods 45 cases of surgical specimens with metastasis were selected as the research object and 50 cases of primary tumors in the same period were compared. All materials were stained with immnnohistochemical method that marked Ki-67, CD31, D2-40, and then micro vessel density （MVD） and lymphatic microvessel density （LMVD） in each group were calculated. Results The total metastatic rate was 5.45%, the blood metastatic rate was 1.33% and the lymph node metastatic rate was 1.09%. MVD of metastatic GIST was 398.39 ± 68. 20/mm2and MVD of non-metastatic GIST was 192. 07 ± 56. 85/mm2, and the difference between them was statistically significant. There was no lymphatic vessels distribution in the essence of GIST regardless of metastasis. About metastatic GIST, LMVD of the edge area of the essence was 13.28 ± 2.40/mm2 and LMVD of normal tissue around the essence was 25.36 ± 6. 71/mm2. In regard to non-metastatic GIST, LMVD of the edge area of the essence was 12. 21 ± 1.83/ mm2 and LMVD of normal tissue around the essence was 24. 23 ± 8.64/mm2. No statistically significant existed between LMVD of the edge area of the essence and LMVD of normal tissue around the essence. All of the 9 cases of lymph node metastatic GIST and 12 from 86 cases of non-metastatic GIST showed invasive growth. Conclusion MVD of metastatic GIST is higher than that of non-metastatic GIST. There is no lymphatic vessel within the essence of GIST. The invasive growth way may be the cause of the lymph node metastasis.
出处
《临床与实验病理学杂志》
CSCD
北大核心
2017年第9期982-986,共5页
Chinese Journal of Clinical and Experimental Pathology
关键词
胃肠道肿瘤
胃肠道间质瘤
淋巴结转移
病理
gastrointestinal neoplasm
gastrointestinal stromal tumors
lymph node metastasis
pathology
