胃肠间质瘤的临床病理观察及免疫组化分析

Gastrointestinal Stromal Tumors Clinical Pathology Observed and Immunohistochemistry Analysis

目的探究胃肠间质瘤患者的临床病例还有对其免疫组化进行分析,了解其对胃肠间质瘤患者的临床意义。方法选自本院2008年至2010年收治的胃肠间质瘤患者共60例,对其临床资料以回顾性的方法进行分析,归纳总结胃肠间质瘤的临床还有病理学特点。结果本次研究中患者胃肠间质瘤发生部位具体为：26例胃、18例小肠、6例腹膜后、4例结肠、肠系膜、食道还有大网膜患者各2例。光镜检查后显示瘤细胞梭形还有上皮样,有的能够见到出血、坏死,患者核分裂1-15个/50HP。免疫组化检测结果如下：CD117阳性表达率为（58/60）、CD34为（46/60）、SMA（4/60）、Vimentin（36/60）,其中有20例患者恶性GISTs为Ki-67。结论胃肠道间质瘤一般在中老年人中出现,出现位置多在消化道,其组织学形态的特点没有显著特异性,在临床上和神经鞘瘤、纤维瘤还有平滑肌瘤容易出现混淆,合理应用CD117还有CD34能够提高临床诊断正确率。

Objective To explore the patients with gastrointestinal stromal tumors of the clinical observation and immunohistochemical analysis, to understand its clinical significance in patients with gastrointestinal stromal tumor. Methods In our hospital from 2008 to 2010 years were selected from the patients with gastrointestinal stromal tumors were 60 cases, and the clinical data were retrospective analysis, summarized the gastrointestinal stromal tumor in clinical and pathological features. Results The study of patients with gastrointestinal stromal tumor location specific： 26 cases of stomach, small intestine 18 cases, 6 cases of retroperitoneal, 4 cases of colon, esophagus and mesentery, greater omentum in 2 patients with. Light microscopic examination showed that the tumor cells were spindle shaped and after epithelioid, some can see hemorrhage, necrosis, nuclear fission of 1-15 in patients with 50 HP. Immunohistochemical results are as follows： the positive rate of CD117 expression（58/60）, CD34（46/60）, SMA（4/60）, Vimentin（36/60）, including 20 cases of patients with malignant GISTs Ki-67. Conclusion Gastrointestinal stromal tumor in general in the elderly, the position in the digestive tract, the morphology of no significant specificity, easy to appear in the clinic and schwannoma, fibrous tumor andleiomyoma confusion, the reasonable application of CD117 and CD34 can improve the accuracy of clinical diagnosis.