胃间质瘤患者内镜及病理免疫组化分析

Invstigation on gastric stromai tumor by endoscopic and pathology and immunohistochemitry

目的 总结胃间质瘤患者的内镜、病理和免疫组化特征,探讨胃间质瘤的诊治方法.方法 回顾性分析2006年1月～2009年12月经手术病理证实的31例胃间质瘤患者的临床资料,包括好发部位、电子胃镜及超声胃镜表现、生物学危险程度及组织学特点.结果 31例胃间质瘤患者均为术后病例,术前完善电子胃镜、超声内镜检查提示胃间质瘤诊断,术后免疫组化检查CD117^＋,31例（100%）、CD34^＋ 28例（90.3%）.根据肿瘤大小、核分裂相、有无破裂确定肿瘤生物侵袭危险程度：极低度侵袭危险性6例（19.4%）,低度侵袭危险性11例（35.5%）,中度侵袭危险性10例（32.3%）,高度侵袭危险性4例（13%）.结论 胃间质瘤患者临床表现无特异性,电子胃镜及超声内镜检查有助于提高术前诊断率,术后病理及免疫组化检查可明确诊断,生物学特性的分析有利于更好地指导临床.

Objective To investigate the diagnosis and treatment of gastric stromal tumor by summarizing the endoscopiegastrie,pathological,immunohistochemical features. Methods 31 cases of gastric stromal tumors confirmed by pathology between January 2006 to December 2009 were analysed retrospectively,including the predilection sites, electronic endoscopy, endoscopic ultrasound （EUS） , the degree of malignancy and histological features. Results 31 cases of gastric stromal tumor underwent surgery,which were dignosed as gastric stromal tumors by electronic endoscopy and EUS preoperatively. Postoperative immunohistoehemistry showed： CD117 （ ＋ ） in 31 eases （ 100% ）, CD34 （ ＋ ） in 28 cases （90.3 % ）. We distinguished pathological risk stratification according to tumor size, mitotic, with or without rupture of the tumor：very low risk in 6 eases （19.4%）, low risk in 11 cases （35.5%）, intermediate risk in 10 cases （32.3%） ,high risk in 4 cases（ 13% ）. Conclusions Gastric stromal tumors had no specific clinical features,electronic endoscopy and endoscopic ultrasound helped to increase the rate of diagnosis, pathology and immunohistochemistry confirmed the diagnosis,and the analysis of biological characteristics was beneficial to clinical work.