46例胃肠道间质瘤临床病理分析

A Clinic-Pathological Aanalysis of 46 Cases with Gastrointestinal Stromal Tumors

目的 探讨胃肠道间质瘤 (GIST)的组织起源、临床病理和免疫组化特点。方法 对 46例GIST标本进行临床病理观察及免疫组织化学检查。结果 46例GIST中良性 8例 ,交界性 14例 ,恶性 2 4例 ;瘤细胞为梭形或上皮样 ,或两者混合存在 ;免疫组化表型为CD117和CD3 4,阳性率分别为 95 6%及 67 4%,Desmin及S -10 0少数病例灶性阳性。结论 GIST可能起源于多潜能的、卡哈尔间质细胞样的前体细胞 ,是胃肠道最常见的间叶性肿瘤 ,有较为独特的组织学形态 ,免疫组织化学CD117敏感性强、特异性高 ,是胃肠道间质瘤可靠的标记物 ;CD3 4表达率较高 。

Objective To investigate the source, the morphological and immunohistochemical characteristics of gastrointestinal stromaltumors (GIST). Methods In the study of the clinicopathologic characteristics of 46 cases of GIST, all cases were detected with immunohistochemical method.Results Of 46 cases, 8 were benign,14 were bordline and 35 were malignant. The neoplastic cells of GIST were spindle, epithelioid or both in different proportion. Immunohistochemically, the positive rates of CD117 and CD34 were 95.6%, 67.4%, desmin and less S-100 cases showed focal expression.Conclusions GIST may originate from the pluripotential precursor cells like the interstitial cells of Cajal. It is the most frequent mesenchymal tumor seen in the gastrointestinal tract with special morphologic. CD117 is a useful marker to recognize GIST. The rate of CD34 is higher in GIST and this may be helpful to the diagnosis.