胃肠道间质瘤23例的临床诊治分析

Clinical diagnosis and treatment of 23 cases of gastrointestinal stromal tumors

目的探讨胃肠道间质瘤的临床和病理特征，免疫组织化学在诊断中的价值及肿瘤的治疗方式与预后。方法回顾性分析我院2000～2005年23例胃肠道问质瘤患者影像学检盘、大体及光镜观察、SP免疫组织化学方法检测CD117、CD34、S100、SMA等抗原标记物在肿瘤中的表达情况，手术治疗和其他治疗的效果。结果恶性18例，良性5例；肿瘤组织中抗原标记物表达均为CD117和CD34阳性，S—100阴性。23例均行手术切除，1例术后使用依马替尼。门诊随访，9例存活，2例死于本病，1例死于肺梗塞，11例失访。结论该疾病恶性程度的高低主要在于肿瘤的大小及异型性，核分裂象的多少。免疫组织化学在诊断中占重要的地位．治疗方案中手术治疗效果较好。

Objective To investigate clinical and pathological characters, the value in the diagnosis of immunohistochemical study, treatment and prognosis of 23 cases of gastrointestinal stromal tumors. Methods The clinical data of 23 patients with gastrointestinal stromal tumors from 2000- 2005 were analyzed retrospectively in our hospital. The imageological examination and morphologic characteristics were studied and some tumor specific antigens including CD117, CD34, S-100 and SMA were detected in all the cases with SP immunohistochemistry staining. The effect of operative treatment and other treatment were researched. Results 18 cases were malignant and the rest were benign. CDll7 and CD34 showed strong expression in all cases while S-100 protein was absent. All patients were carried out surgical resection, one patient took STI 571 after operation. After followed up, 9 cases were alive, two cases died of this disease, one case died of pulmonary embolism, 11 cases were out of followed. Conclusion The malignant degree of GIST depends on the size and atypia of tumor and mitotic count. Immunohistochemical study plays an important role in the identification of GIST. Operative treatment is the most effective measure for the GIST patients.