胃肠道间质瘤形态学及免疫组化研究

Morphologic and immunohistochemical study of gastrointestinal stromal tumor

目的研究胃肠道间质瘤(GIST)的病理形态及免疫组化特点。方法应用光镜观察50例GIST的形态特征,用免疫组化S-P法检测CD117、CD34、Vimentin、Desmin、SMA及S-100蛋白在GIST中的表达情况。结果GIST的瘤细胞较经典的平滑肌瘤更丰富,胞质嗜酸性较弱。瘤细胞梭形或上皮样,或梭形与上皮样细胞混合存在,胞质内常见空泡形成;瘤细胞排列成交织束状、弥漫片状、栅栏状或轮辐状,较为特征的是细胞团巢形成。常见间质或血管壁玻璃样变。原发于肠系膜者恶性潜力较高。CD117和CD34的阳性率分别为98%和92%。结论胃肠道间质瘤有较为独特的组织学形态,CD117和CD34联合使用可协助鉴别诊断。

Objective It is to study the pathomorphological and immunohistochemical features of gastrointestinal stromal tumor （GIST）. Methods The morphologic characteristies of 55 GIST patients were observed with light microscopy, The expressions of CDl17, CD34, Vimentin, Desmin, SMA and S 100 protein in GIST were detected with S-P immunohisto- chemical method. Results GIST had higher degree of cellularity and lesser degree of eosinophilia than classic leiomyomas, The neoplastic cell of GIST was spindle, epithelioid or both in different proportions. Focal to prominent cytoplasmic vacuolization was often seen. The histological spectrum included interlacing fascicles, diffuse sheets, storiform and palisading pattern, The fomation of cell clusters was rather special, Stromal and vascular hyalinization was common, GIST primary in the mesentery had higher potentiality of malignancy. The masculine rates of CDll7 and CD34 were 98 % and 92 % respec- tively, Conclusion GIST has characteristic histological features, The combination detection of CDll7 and CD34 is helpful to differential diagnosis,