胃肠道间质瘤的临床病理特征分析和免疫组化研究  

The clinicopathologic and immunohistochemical features of gastrointestinal stromal tumors

作　　者：付娟娟[1] 宋新兰[1] 贺家勇 

机构地区：[1]新疆维吾尔自治区人民医院病理科,新疆乌鲁木齐830000 [2]乌石化职工医院外科,新疆乌鲁木齐830000

出　　处：《新疆医科大学学报》2011年第2期155-157,共3页Journal of Xinjiang Medical University

摘　　要：目的探讨不同部位发生胃肠道间质瘤（GIST）的临床病理特点及CD117、CD34、SMA、S-100和Vim-entin的表达情况。方法采用免疫组织化学SP法检测84例17~81岁不同部位的胃肠道间质瘤中CD117、CD34、SMA、S-100和Vimentin的表达情况。结果 84例GIST中极低度风险性18例（21.4%）,低度风险性26例（31.0%）,中度风险性15例（17.9%）,高度风险性25例（29.8%）。84例GIST Vimentin、CD117和CD34表达率分别为100.0%、94.0%、86.9%。CD34有3例（86.9%）,SMA和S-100阳性表达率低而多为局灶弱阳性反应。其中SMA 11例（13.1%）,S-1006例（7.14%）。结论发生在胃的高位GIST多为极低度和低度风险性肿瘤,发生在小肠和大肠的低位GIST多为中度和高度风险性肿瘤。Vimentin、CD117和CD34的阳性表达率高并且多呈弥漫强阳性反应。免疫组化联合使用,包括CD117和CD34在内的一组抗体是必要的,能提高GIST的诊断率。但在GIST良、恶性诊断上仍需结合肿瘤的大体、组织学形态及生物学行为等综合考虑。Objective To investigate the clinicopathologic and immunohistochemical features of gastrointestinal stromal tumors（GISTs） and the expression of CD117,CD34,SMA,S-100.Methods The clinicopathologic features were studied,and the expression of CD117,CD34,SMA,S-100 and Vimentin were detected with immunohistochemical SP staining in 84 cases of GIST.Results The rate of the lowest risk tumor was 21.4%,and the low risk tumor was 31.0%.The rate of the midrange risk tumor and high risk tumor were 17.9% and 29.8% respectively.The positive rates of CD117 and CD34 were 94% and 86.9%,the positive rates of SMA and S-100 were 13.1% and 7.14%.Conclusion The gastrointestinal stromal tumors（GISTs） in stomach is always the lowest risk tumor and the low risk tumor.The GISTs in small intestine and large intestine are always the midrange risk tumor and the high risk tumor.The expression of CD117,CD34 and Vimentin are difffused.The combination of CD117 and CD34 immunohistochemical staining is necessary for the diagnosis of GIST.However,the immunophenotype is not a predictor for the degree of malignancy.

关 键 词：胃肠道间质瘤 CD117 CD34 SMA S-100 VIMENTIN 免疫组织化学 

分 类 号：R739.6[医药卫生—肿瘤]