胃肠道间质瘤92例临床病理观察  

Clinical and pathological features of gastrointestinal stromal tumors:an analysis of 92 cases

作　　者：庄严阵[1] 付莉[1] 黄红浪[1] 陈佩琼[1] 

机构地区：[1]福建医科大学附属厦门第一医院病理科,福建厦门361003

出　　处：《中华肿瘤防治杂志》2009年第7期515-518,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的：探讨胃肠道间质瘤（gastroin testinal stromal tumors，GIST）临床病理特征。方法：收集116例手术切除的胃肠道间叶性肿瘤标本，通过常规HE制片，单抗CD117等免疫组化标记确诊GIST92例，分析和观察患者的，临床和病理资料，并复习文献。结果：GIST高峰年龄55～75岁，占胃肠道间叶性肿瘤的79．31％，约15．22％伴发消化道癌。好发部位是胃（54．35％）和小肠（18．48％），其次是肠系膜、结直肠及食管。瘤体大小为0．2～22cm，单发或多发性结节（9．78％）。显微镜下，瘤细胞梭形和上皮样呈束状交叉或弥漫性排列为主，细胞异形性在同一瘤体内的不同区域可存在明显差异，可伴有骨软骨化生（4．35％）。免疫组化，瘤细胞表达CD117（96．74％）或CD34（89．23％），灶性表达DES、SMA、S-100及NSE。结论：GIST是具独特的临床表现和组织学上高度异质性、免疫表型上表达c—kit蛋白（CD117）的胃肠道最常见的间叶源性肿瘤；掌握其临床病理特点有助于治疗方案的拟定。OBJECTIVE： To study the clinical manifestation and pathological features of gastrointestinal stromal tumors （GISTs）. METHODS： A total of 116 cases of gastrointestinal mesenchymal tumours specimens were obtained, and 92 cases were confirmed in all cases by microscopic examination with hematoxylin and eosin stain and positive immunoreaction for c-kit. The simultaneously clinical information of these patients and the literature were reviewed. RESULTS： GISTs frequently occurred in 55-75 years old, and 15.22% with digestive tract cancer. The frequently occurring parts were stomach （54.35%） and small intestine （18.48%）, followed by mesentery, rectem and colon, and esophagus. The tumor size was 0.2-22 cm,solitary or mulifocality （9.78%）. The spindle or epithelioid tumor cells mostly arranged in fascicles and sheets. The cell heteromorphism had the obvious difference in one specimen, with chondrometaplasia （4.35%）. The tumor cells expressd CD117 （96.74%） or anti CD34 （89.23%）, and had focal positive staining for desmin, smooth-muscle actin, S-100 protein and NSE. CONCLUSIONS： Gastrointestinal stromal tumors （GISTs） are the most common gastrointestinal mesenchymal tumor, with distinct clinical manifestation and histological heterogeneity, and immunohistochemistry tumor cell expressing CDl17 （C-kit, KIT）. To grasp the clinicopathologic features is very important to formulate the treatment plan.

关 键 词：免疫组织化学 胃肠道间质肿瘤/病理学 抗原 CD34/生物合成 

分 类 号：R735[医药卫生—肿瘤]