胃肠间质瘤的临床病理特征

目的探讨胃肠道及胃肠外间质瘤(GIST)的临床、病理和免疫组化特征。方法用免疫组化S-P法观察了53例GIST的CD117、CD34、SMA、Desmin和S-100蛋白表达并分析其与临床病理的关系。结果53例间质瘤中梭形细胞型38例,上皮样细胞型6例,混合型9例;良性9例,交界性20例,恶性24例;9例良性间质瘤,8例发生在胃,而肠和胃肠外间质瘤仅1例良性。CD117、CD34免疫组化阳性表达率分别为92.45%及77.36%。结论GIST有其独特的形态特征;CD117和CD34同时检测有助于GIST的诊断;肠和胃肠外GIST的恶性潜力较胃GIST高;GIST良恶性的评估取决于肿瘤的部位、大小和核分裂的多少。

The clinical and pathologic characteristics of gastrointestinal stromal tumor

Objective To explore the clinical, pathologic and immunohistochemical characteristics of gastrointestinal stromal tumor (GIST) and stromal tumor beyond the gastrointestinal tract. Methods Expression of CD117, CD34, SMA, Desmin and S-100 protein in 53GIST were detected using immunohistochemical S-P method, and then analyzed. Results Of 53 cases, 38 cases were detected as spindle type, 6 as epithelioid type and 9 as mixture type; 9 cases were benign,20 were borderline and 24 were malignant. Of the 9 benign cases, 8 originated in stomach, while only one originated in intestine and beyond the gastrointestinal tract. The rate of immunohistochemical expression was showed as follows: CD117 92.45% and CD34 77.36%. Conclusion GIST has its unique morphological characteristics. To detect CD117 and CD34 simultaneously may be helpful to the diagnosis. The malignant potential of stromal tumor in intestine and beyond the gastrointestinal tract is higher than that in stomach. The estimation of benignancy and malignancy depends on the site, the size and nuclei mitoses of the tumor.