胃肠道间质性肿瘤的病理学研究

PATHOLOGIC STUDY OF GASTROINTESTINAL STROMAL TUMORS

胃肠道间质性肿瘤是一类发生于胃肠道的异质性肿瘤。包括起源于平滑肌、雪旺氏细胞及胃肠道肌神经丛的三大类肿瘤。它们的组织学形态十分相似，极易混淆。本文报告４８例，用通常的病理组织学诊断标准分类，并用Ｍａｓｓｏｎ三色染色及四种不同的单克隆抗体作免疫组织化学检查，试图说明它们的形态特征及组织发生。然而出现反常的及相互矛盾的结果。超微结构检查有助于鉴别诊断。另外，光镜下的良性肿瘤而在临床上是侵袭性的，手术后可出现复发与转移。判断这类肿瘤的生理学行为，要进行１０年或１０年以上的长期随访。

astrointestinal stromal tumors(GIST)are a group of three types of het-erogeneous tumor derived from the smooth muscles/Schwann cells and myentericplexus of the gastrointestinal tract. Histologically they are very similar and thediagnosis is often confused.Forty-eight cases were retrospectively studied,classified by conventionalhistologic diagnostic criteria,stained by Masson’s trichrome stain and treatedwith four different monoclonal bodies,i.e. vimentin,desmin,NSE and S一100.The authors tried to explain their morphological patterns and explore their histo-genesis,but the result appeared abnormal and contradictory.Electron micro-scopic study may be useful for differential diagnosis,Light microscopic appear-ance suggested benign neoplasms while their biological behavior was aggressivecausing recurrence or metastasis after surgery.Follow-up for ten or more yearsknecessary to determine their nature