小肠间质瘤的免疫组织化学特征其意义

Immunohistochemical characteristics and its significance of intestinal stromal tumors

目的探讨小肠间质瘤的临床病理诊断及免疫组织化学特征。方法收集我校附属医院临床病理科6年来对外科手术切除的小肠肿瘤标本,光镜观察、免疫组织化学方法检测Vimentin、desmin、S-100、actin、CD117、CD34和SMA的表达。结果13例肿瘤中良性3例,潜在恶性4例,恶性6例;其中黏膜下生长3例,浆膜下生长5例,肠系膜处生长2例,肌壁内生长3例,常见症状是上腹部肿块和上消化道出血,免疫表形特征为:CD11713例(100%)胞质阳性表达;CD3410例阳性(76.9%)表达,S-100蛋白2例(15.4%)呈局灶表达,10例SMA阴性表达。结论小肠间质瘤发生率较高,多为恶性,有必要和肠的雪旺细胞瘤、平滑肌瘤相区别,CD117、CD34可作为诊断小肠间质瘤免疫标记物,而肿瘤大小、有无出血和坏死、核分裂像等均可作为良恶之判断的参照指标。

Objective To explore the clinicopathological and immunohistochemical characteristics of intestinal stromal tumors（GIST）. Methods The gastric tumor were studied with light microscopy. The expression of Vimentin desimin S-100, CD117, CD34 and SMA were further determined by SP method of immunohistochemistry. Results Among 13 tumor cases, 3 cases were innocence, 6 malignant, and 4 cases showed potential tendency. Among the total, 3 cases existed beneath mucosa, 5 beneath starch membrane, 2 at instinal membrane and 3 within muscular walls. The most commen symptoms were abdomen mass, vague pain and GT bleeding, the external features of immunohistochemistry showed that 13 cases with CD117 （100%） stained positive, 10 cases （76.9%） with CD34 pasitive, 2 cases with S-100 protein focally expressing, and 10 cases with SMA negative. Conclusion The stromal tumors are the most common mesenchymal tumors and CD117, CD34 can be used as immune markers to diagnose gastric stromal tumor.