消化道间质瘤的临床病理分析及免疫组织化学观察  

Clinicopathological Analysis and Immunohistochemical Observation of Gastrointestinal Stromal Tumor

作　　者：商少宏[1] 张海萍[2] 王淑真[2] 

机构地区：[1]福建医科大学附属厦门第一医院肿瘤中心,厦门361003 [2]福建医科大学附属厦门第一医院病理科,厦门361003

出　　处：《福建医科大学学报》2005年第2期188-191,F003,共5页Journal of Fujian Medical University

摘　　要：目的　探讨消化道间质瘤(GIST)的临床病理、免疫组织化学特点与肿瘤恶性程度及治疗预后的关系。　方法　用免疫组织化学(SP法)检测33例原发性GIST患者的间质瘤细胞c kit蛋白(CD117)、CD3 4 、波形蛋白、结蛋白、S 10 0、Syn、NSE、αSMA、ACT、FN、GFAP表达。　结果　33例GIST中,良性者8例,交界性7例,恶性共18例。位于小肠者均为交界性及恶性,其恶性度与其它部位的肿瘤相比差异有显著性(P <0 .0 5 )。所有病例CD117、波形蛋白均阳性,2例CD3 4 阳性;而结蛋白、FN、GFAP均阴性。2 2例a SMA、ACT阳性,16例S 10 0阳性,其中3例Syn、NSE阳性。交界性及恶性肿瘤出血坏死明显与良性者有差异显著性(P <0 .0 1)。随访19例,良性及交界者治疗效果较好,恶性者则差。　结论　GIST好发于中老年人。几乎所有GIST均表达CD117及波形蛋白,大部分表达CD3 4 。肿瘤的恶性程度及预后与其发生部位、大小、出血坏死、细胞异形性及核分裂活性密切相关。Objective To probe the relationship between the clinicopathological, immunohistochemical characteristics of gastrointestinal stromal tumor(GIST) and its malignant degree and prognosis. Methods The expression such as CD 117 , CD 34 , vimentin, desmin, S-100, Syn, NSE, α-SMA, ACT, FN, and GAFP have been tested by immunohistochemical (S-P method). Results All GIST lie on small intestine were borderline or malignant, and their malignant degree were significantly higher(P<0.05) than the tumor on other digestive tract. CD 117 and vimenten were 100% positive, 67% CD 34 was positive,desmin, FN, and GFAP were negative. 22 cases α-SMA, ACT were positive and 16 cases S-100 were positive, and for 3 cases Syn and NSE are positive. Among 33 cases of GIST, 8 cases were benign, 7 cases were borderline, and 18 cases were malignant. In cases of borderline and malignant tumors, the hemorrhagic and necrosis were noticeable that have significantly different(P<0.01)as comparing with the benign. 19 cases of this group of patients have follow-up, and the result revealed that therapeutic effect for the cases of benign and borderline GIST were better the case of malignant tumor. Conclusion GIST was favor able occurrence in middle-aged .Almost all GIST express CD 117 (c-kit) and VIM, and most GIST express CD 34 . Malignant degree and prognosis of tumor correlate intimately with occurrence site, tumor size, hemorrhagic necrosis, abnormal cellular morphology and mitotic activity.

关 键 词：原癌基因蛋白质c-kit类 胃肠肿瘤 间叶瘤 随访研究 免疫组织化学 

分 类 号：R735[医药卫生—肿瘤]