35例胃肠道间质瘤的临床病理及免疫组织化学探讨

A Clinicopathology and Immunohistochemical Study on 35 Cases of Gastrointestinal Stromal Tumors

目的:探讨胃肠道间质瘤(GISTs)的病理组织形态和免疫组织化学特点及其在良性、潜在恶性、恶性临床分布特点。方法:选用35例临床资料完整、病理诊断准确的病例(均经免疫组织化学测定CD117、CD34、SMA、S-100、NSE)。结果:35例GISTs恶性(包括潜在恶性)达85.0%以上;组织形态以梭形细胞为主23例(65.7%),上皮样细胞7例(20.0%),混合型5例(14.2%);免疫组织化学阳性表达率CD11774.3%(26/35例)、CD3468.6%(24/35例)、NSE65.7%(23/35例)、S-10031.4%(11/35例)、SMA48.6%、(17/35例);向神经分化13例,向平滑肌分化5例,双向分化12例,未分化5例。结果:GISTs是消化道最常见的间叶性肿瘤,CD117及CD34等免疫标记物配合使用,可起互补作用并对其作出正确诊断。

Objective: To explore the morphologic and immunohistochemical features of gastrointestinal stromal tumors (GISTs) and the distribution features of pathologically benign, potential malignancy, malignancy. Methods: To select 35 cases which had complete clinical records and correct pathologic diagnosis, we use the immunohistochemical staining for CD117, CD34, SMA, S-100, NSE to all cases. Results: In 35 cases of GISTs, malignant (include potential malignancy) occupy 85% over. 23 cases were spindle cell type (65.7%), 7 cases were epithelioid cell type (20%) and 5 cases mixed cell type (14.2%). Immunohistochemical positive staining showed: CD117 74.3% (26/35cases), CD34 68.6% (24/35 cases), NSE 65.7% (23/35 cases), S-100p 31.4% (11/35 cases), SMA 48.6% (17/35 cases). Neural and smooth muscle differentiation were observed in 13 and 5 cases. Both smooth muscle and neural differentiation were 12 cases. No neural or smooth muscle differentiation were 5 cases. Conclusions: GISTs were the most frequent mesenchymal tumor seen in the gastrointestinal tract. The application of immunohistochemical markers CD117 and CD34 are mutually benefit for a final correct diagnosis.