胃肠道间质瘤临床病理分析及诊治探讨

A Clinicopathological Study on Gastrointestinal Stromal Tumors

目的:探讨胃肠道间质瘤的临床病理特征、免疫组化特点、生物学行为以及诊治情况。方法:采用免疫组化S-P法检测29例胃肠道间质瘤CD117,CD34,SMA、Desmin、NSE、S-100等蛋白的表达情况,并进行临床病理分析。结果:29例胃肠道间质瘤CD117阳性表达26例占89.7%,CD34阳性表达21例,占72.4%。随访18例病人,有8例复发或死亡,其中NSE和(或)S-100蛋白阳性表达6例。在潜在恶性和恶性患者CD117、CD34、SMA、NSE、S-100等蛋白的表达与良性患者有明显差异,但Desmin的表达两者没有差异。结论:胃肠道间质瘤CD117及CD34是较特异的标记物。NSE、S-100蛋白阳性表达者在判定恶性时需高度重视,应行根治性切除。

Objective： To investigate the clinicalpathological characteristics and prognosis and treatment of gastrointestinal stromal tumors. Methods： 29 cases were detected by immunohistochemical method and diagnosed as GISTs. Their pathological features,immunohistochemical phenotypes, clinical manifestations were analyzed. Results： 26 cases were positive for CDl17 （89.7%） ,21 cases were positive.for CD34（72. 4%）. 8 cases recurred and died, including 6 cases were positive for NSE or 8-100. Conclusions： The diagnosis of GIST depends on pathological observation and immunohistochemical study. CD117 is a sensitive marker for the diagnosis of GIST. Surgical resection is the choice for treating GIST, especially the case with positive for NSE or S-100.