胃肠道间质瘤临床病理及免疫组织化学特征

Gastrointestinal stromal tumors: immunohistochemical and clinicopathologic studies

目的 探讨胃肠道间质瘤的免疫组织化学特征 ,为其诊断及鉴别诊断和预后提供依据。方法 对消化道内 16 9例间叶源性肿瘤进行免疫组织化学标记和形态学观察 ,确诊 113例胃肠道间质瘤。结果 肿瘤多见于胃 ,临床常见首发症状为消化道出血及腹部包块。瘤细胞主要有梭形细胞及上皮样细胞两种形态 ,梭形细胞型 70例 ,上皮样细胞型 10例 ,混合细胞型33例。相对良性 33例 ,交界性 2 6例 ,恶性 5 4例。免疫表型 :CD117阳性 112例 ,CD34阳性 10 2例 ,阳性率分别为 99.1%及90 .2 % ,且呈弥漫强阳性表达。结论 胃肠道间质瘤是消化道最常见间叶源性肿瘤 ,以胃内多见 ;主要有 2种细胞形态和 3种组合形式 ;确诊需要依靠CD117。

Purpose To explore the histogenesis, immunohistochemical and clincopathologic characteristics of gastrointestinal stromal tumors. Methods A total of 113 cases of the gastrointestinal stromal tumors were distinguished from 169 cases of the mesenchymal tumors in alimentary tract by S-P immunohistochemical staining methods. Results All patients were adults, the most common symptoms were GI bleeding and abdomen mass. Microscopically, the tumors were composed of spindle cells (70 cases), epithelioid cells (10 cases), or both cells (33 cases). 33 cases were benign, 26 cases were borderline and 54 cases were malignant. Immunohistochemically, CD117 and CD34 showed diffuse strong expression, and the positive rates were 99.1% (112/113) and 90.2% (102/113) respectively. Conclusions Gastrointestinal stromal tumors were the most common mesenchymal tumors seen in the alimentary tract. Immunohistochemical detection of CD117 and CD34 is necessary for its differential diagnosis.