胃肠道间质瘤病理及免疫组化分析

Clinicopathological and immunohistochemical studies in 36 cases of gastrointestinal stromal tumor

目的探讨胃肠道间质瘤(GIST)的临床病理、免疫组织化学特点。方法应用常规病理观察36例GIST的形态特征,用免疫组织化学SP法检测CD34、CD117、vimentin、SMA、NSE、S-100蛋白在GIST中表达。结果本组GIST镜下瘤细胞以梭形细胞和上皮样细胞为主,或两种混合存在,成束状、栅栏状、旋涡状或巢状排列。36例中良性12例,交界性14例,恶性10例。免疫组织化学表型CD34和CD117阳性的阳性率分别为80.5%和94.4%,而vimentin、SMA、S-100蛋白在肿瘤向平滑肌或神经方向分化时阳性。结论GIST由梭形细胞或上皮样细胞构成,组织结构形态多变,但免疫表型完全一致;CD117及CD34阳性可作为GIST诊断及鉴别诊断的重要参考依据。

Objective To investigate the pathological and immunohistochemical features of gastrointestinal stromal tumor （GIST）. Methods Thlrty-six cases of GIST were studied by histopathology and immunohistochemistry. The expressions of CD34, CDll7,vimentin, SMA, NSE and S-100 protein were detected with S-P immunohistochemical method. Results The neoplastic cells of GIST were mainly spindle, epithelioid, or both, which arranged in bunch, fence, vortex or nest. Among 36 cases, 12 were benign, 10 malignant and 14 borderline lesions. The positive rats of CD117 and CD114 were 94. 4% and 80. 5%, respectively. The expression of vlmetin ,SMA and S-100 in GIST was positive when neoplastic cells differentiated towards smooth muscle or nerve. Conclusions The neoplastic cells of GIST are spindle or epitheloid. Histostructures vary a lot, but immunophenotypes are all the same. CD117 and CD34 may be taken as the markers in the diagnosis and differential diagnosis of GIST.