胃肠道间质瘤87例的临床病理学研究

Clinical and pathologic features study of 87 cases of gastrointestinal stromal tumor

目的分析胃肠道间质瘤(GIST)的临床病理学特征。方法对87例胃肠道间质瘤进行HE和免疫组化染色,结合62例随访资料进行分析。免疫组化方法采用EnVision法。结果87例GIST中,CD117表达阳性72例(82.8%),CD34表达阳性62例(71.3%)。其生物学行为评价分为:极低度侵袭危险性17例,低度侵袭危险性23例,中度侵袭危险性23例,高度侵袭危险性24例,随侵袭危险性级别升高,其进展性疾病(PD)发生率升高。结论GIST主要见于中老年人,CD117阳性具有诊断意义,但无预后意义。GIST组织学形态多样,不同组织学类型预后不同。肿瘤大小和核分裂象是评价该肿瘤生物学行为的重要指标,凝固性坏死也可以作为预后评估的参考指标。

Objective To explore the clinical and pathological features of gastrointestinal stromal tumor（GIST）. Methods All 87 cases of GIST were studied by HE and immunohistochemical staining methods. Clinieopathological findings were analysed in 62 cases of GIST combined with followe-up date. Results Among 87 cases of GIST,72 showed CD117 positive and 62 CD34 positive. According to Fletcher＇ s scheme,the cases of GIST were divided into 4 subgroups：very low aggressive risk （ n = 17） ,low risk（ n = 23）, intermediate risk（ n = 23） and high risk （n = 24）. Conclusions The GIST occurs predominantly in the middle and old age patients CD117 positive immuno-staining only is a diagnositie marker of GIST, while the tumor size, mitotic count and coagulative necrosis can be seem as prognostic parameters.