50例胃肠道间质瘤临床病理及免疫组化观察

CLINICOPATHOLOGIC STUDY OF GASTROINTESTINAL STROMAL TUMORS

目的:观察胃肠道间质瘤(gastrointestinal stromal tumor GIST)的临床病理及免疫组织化学特征并讨论其病理诊断标准。方法:对50例胃肠道间质瘤进行形态学观察分析,应用组织芯片技术作免疫组化(S-P法)检测CD117、SMA、NSE表达。结果:70%的GIST发生于胃和小肠,腹膜后及盆腔亦占一定比例。GIST可分别或同时表达SMA、NSE。良性15例,恶性20例,潜在恶性15例。结论:GIST具有一定的临床病理特征,胃肠道梭形细胞肿瘤或上皮样间叶源性肿瘤多系GIST,食管、腹膜后及盆腔梭形细胞肿瘤或上皮样间叶源性肿瘤应常规作免疫组化与GIST鉴别,其良恶性需综合分析、判断。

Objective：To investigate the clinicopathologic features of gastrointestinal stromal tumors（GIST） and discuss their diagnostic criteria.Methods： Light microscopic observation and immunohistochemistry（S-P） with tissue array were done on 50 cases of GIST.Results：70% cases originated in stomach and small intestines,and some of them in meta-peritoneum and cavitas pelvis.The GIST showed two basic cell types-spindle and epithelioid.Some of them were difficult to differentiate from leiomyomas and schwannomas.In this study,the Lewin criteria for diagnoses of benign and malignant GIST were applied.In the whole cases, 15 were benign, 20 malignant and 15 potentially malignant.Conclusion：GIST have some clinic Pathologic features. Gastrointestinal tumors with spindle or epithelioid cell types were mostly GIST.These same tumors in esophagus, meta-peritoneum and cavi- tas pelvis should be differentiated from GIST through immunohistochemistry .The judgement of benign and malignant natures may depend on overall analyses.