30例胃肠道间质瘤的临床病理分析

A clinicopathologic study of gastrointestinal stromal tumors:30 cases

目的观察胃肠道间质瘤(gastrointestinal strom al tumors,G ISTs)的临床病理和免疫组化特点并探讨其概念及诊断标准。方法30例G ISTs行常规检查及免疫组化染色。结果G ISTs由梭形细胞和上皮样细胞构成,可分为四个亚型:平滑肌细胞分化型40%;神经源性分化型10%;平滑肌和神经双向分化型20%;未分化型30%。未分化型间质瘤的免疫表型为V im entin和CD34阳性(100%)。本组研究按Lew in提出的标准判断G ISTs的良恶性,结果为良性G ISTs15例,潜在恶性G ISTs6例,恶性G ISTs11例。结论尽管G ISTs的光镜下形态相似,但其免疫组化表型却呈异源性,需要做免疫组化以准确定性。

Aim To investigate the clinicopathologic and immunohistochemical features of gastrointestinal stromal tumors （GISTs） and discuss their concepts and diagnostic standards. Method 30 cases of GISTs were studied by routine stain and immunohistochemistry. Results The GISTs showed two basic cell types - spindle and epithelioid. The neoplasms were classified as follows ： 40% smooth muscle tumors; 10% neurogenic differentiated tumors; 20% mixed smooth muscle cell and neurogenic differentiated tumors; 30% undifferentiated GISTs, not other specified. The immunophenotype of undifferentiated GISTs was vimentin and CD34 （ 100% ）. In this study, the Liwin＇s criteria for the diagnoses of benign and malignant GISTs were applied. In the 30 cases, there were 15 cases benign, 6 potential malignant and 11 malignant GISTs. Conclusion Despite their similar light microscopic appearance, GISTs are immunophenotypically heterogeneous, requiring immunohistochemical studies for accurate characterization.