胃肠道间质瘤临床病理观察

A clinicopathological study of gastrointestinal stromal tumor

目的总结胃肠道间质瘤的临床病理特点，探讨其诊断及鉴别诊断。方法观察62例胃肠道间质瘤的病理形态，采用免疫组织化学S—P法检测CD117、CD34、SMA和S-100，结合临床资料进行分析。结果间质瘤细胞主要为梭形和上皮细胞样细胞，部分胞质内可见核端空泡或将细胞核推挤到一侧呈印戒细胞样。组织结构呈多样性，可呈束状、弥漫状、栅栏状、巢状或血管外皮瘤样等。62例CD117阳性，47例CD34阳性，30例SMA阳性，21例S-100阳性。结论CD117及CD34是胃肠道间质瘤较特异的标记物，SMA和S-100在胃肠道间质瘤中有不同程度的表达。胃肠道问质瘤需与多种疾病进行鉴别。

Objective To explore the diagnosis and differential diagnosis of gastrointestinal stromal tumor （GIST） by studing clinicopathological feature. Methods Immunohistochemistry was used to detect CD117, CD34,SMA and S - 100, and clinical and pathological features of GIST were analyzed. Results GIST cells were mainly spindle and epithe- lioild ceils, some bubble could be seen in the end of and the nucleus in cytoplasm, some showed signet - ring cell, his- tology structure showed various including sarciniform, diffuse, palisade, nestification and hemangiopericytoma etc. 62 specimen were positive with CDll7, 47 specimen were positive with CD34, 30 specimen were positive with SMA, 21 specimen were positive with S - 100. Conclusion CDll7 and CD34 are specific marker in GIST,SMA and S - 100 shows different degrees of expression. It is important to make differential diagnosis with other diseases.