胃肠道间质瘤临床病理分析

Analysis of the clinicopathology and immunohistochemistry on gastrointestinal stromal tumors

目的探讨胃肠道间质瘤（GIST）的组织病理形态和免疫组织化学特点。方法应用免疫组织化学Supervision^TM法对原发性GIST组织中的CD117、CD34、SMA、desmin、S-100蛋白进行研究。结果本组GIST发病年龄在42—77岁（平均56岁）。男性8例，女性11例。肿瘤组织形态为梭形细胞和上皮样细胞。梭形细胞呈交叉束状、旋涡状、席纹状排列；上皮样细胞多呈弥漫片状或巢状排列。可以伴有囊性变、粘液变、出血及坏死、核分裂象大于或等于5／50HPF的3例中肿瘤直径均大于5cm。免疫组化染色CD117和CD34多为弥漫强阳性，阳性率分别为94．74％和73．68％。SMA不表达或者呈灶性阳性，S-100蛋白和desmin阴性。结论GIST好发生在中老年，肿瘤细胞形态多变，排列方式多样，免疫组织化学染色CD117阳性对诊断有确定作用，CD34表达对诊断也有重要意义。

Aim To study the histopathological and immunohistochemical staining on gastrointestinal stromal tumor（GIST）. Methods GIST were performed in the primary gastrointestinal tumors for a panel of antibodies such as CDll7, CD34, SMA, desmin, S-100 protein by supervision^TM. Results The patient＇s ages ranged from 42 years to 77 years （ mean 56 years）, including 8 males and 11 females.The tumor cells consisted of spindle shaped cells and epithelioid cells. The spindle shaped cells arranged in fascicular, whorled, and storiform ; The epithelioid cells arranged in diffusing sheets of ＂ nest＂ appearance. The mitotic count was higher than 5/50HPF in 3 cases which were over or equal 5cm in diameter, hnmunohistochemically, CD117 and CD34 showed diffuse strong expression. The positive rates were 94.7% and 73.7% respectively. Desmin and S-100 protein were almost never present. SMA was focally present or absent. Conclusions GIST predominantly occurred in middle aged or older patients, with various kinds of cell types and different arrangements. The immunohistochemical characters were positive for CD117 and CD34. CD117 have certain function to the diagnosis, and CD34 also have significance in diagnosis.