52例胃肠道间质瘤临床与病理分析

A clinicopathologic study of 52 cases of gastrointestinal stromal tumors

目的 探讨胃肠道间质瘤(gastrointestinal stromal tumoua,GIST)的临床表现、组织学和免疫组织化学(免疫组化)的特点及治疗方法。方法 对1987年1月至1999年12月收治的52例GIST患者的临床和组织学资料进行回顾性分析,并应用4种抗体(C-kit、CD34、SMA、S-100)通过免疫组化方法进行分析研究。结果 本组GIST主要发生于胃(42.3％,22/52)和小肠(36.5％,19/52),结直肠较少(21.2％,11/52);良性18例,潜在恶性4例,恶性30例。淋巴结转移率3.6％(1/26),C-kit阳性表达率92.3％(48/52),CD34阳性表达率86.5％(45/52)。肿瘤切除率100％。结论 GIST是胃肠道最常见的间叶性肿瘤,临床表现和组织学检查无特异性。C-kit(CD117)和CD34标记阳性是确诊GIST最有价值的诊断依据,GIST的淋巴结转移率低,手术切除是主要的治疗手段。

Objective To investigate the clinical, histological and immunohistochemical features and the therapy of gastrointestinal stromal tumors(GISTs). Methods Clinical and histochemical data of 52 cases with GISTs from January 1987 to December 1999 were analyzed retrospectively. Four kinds of antibodies(C-kit, CD34, SMA, S-100) were used for immunohistochemical staining. Results The GISTs in this study predominanfiy originated in the stomach (42.3%) and the small intestine(36.5%). Among 52 cases, 18 cases were benign, 4 potentially malignant and 30 malignant. The incidence of lymph node metastasis were only 3.6%. The positive rates of C-kit and CD34 were 92.3% and 86.5% respectively. All tumors were resected. Conclusions GISTs are the most common mesenchymal tumors in gastrointestinal tract and have no specific clinical and histological characteristics. C-kit and CD34 expression is most useful for the diagnosis. The incidence of lymph node metastasis is lower and resection is the major therapy.