50例胃肠间质瘤的组织病理及免疫组织化学分析  

The Histopathdogic and Immunohistochemical analysis in 50 cases of gastrointestinal stromal tumors

作　　者：张小丽[1] 阳帅[1] 赵强[1] 许春伟[2] 张博[2] 

机构地区：[1]南华大学附属第一医院病理科,湖南衡阳421001 [2]解放军307医院病理科

出　　处：《华南国防医学杂志》2014年第11期1087-1089,1095,共4页Military Medical Journal of South China

摘　　要：目的探讨胃肠间质瘤(gastrointestinal stromal tumors,GIST)病理组织学特点及免疫组织化学(immunohistochemistry,IHC)指标CD117、DOG-1、CD34的表达与意义。方法回顾性分析50例GIST患者的病理资料,分析总结其病理组织学及IHC特点。结果 50例中,病变部位在胃、小肠、大肠、胃肠外分别为22、19、6、3例,梭形细胞型依次为15例(68.2%)、12例(63.2%)、3例(50%)、3例(100%);上皮样型5例(22.7%)、5例(26.3%)、3例(50%)、0例;混合型2例(9.1%)、2例(10.5%)、0例、0例;CD117阳性47例(94%),DOG-1阳性45例(90%),CD34阳性40例(80%),CD117和/或CD34阴性12例(24%),CD34、CD117、DOG-1同时阴性1例(2%)。SMA阳性13例(26%)、S-100阳性6例(12%)。结论梭形细胞型是GIST的常见类型,上皮样型和混合型次之,但肿瘤发生部位不同,比例不完全相同。CD117、DOG-1、CD34在GIST中高表达,联合SMA,S-100及病理组织形态学可对大多数GIST明确诊断。Objective To explore the histopathological characteristics of gastrointestinal stromal tumors（GIST）and the significance of CD117,DOG-1,CD34 expression.Methods Retrospective analysis of 50 GIST pathological materials was made,analyzed and summarized their histopathological and immunohistochemical features.Results Among 50 cases,diseased regions which located in the stomach,small intestine、large intestine、extraintestinal sites were 22,19,6,3 respectively,spindle cell type 15（68.2%）,12（63.2%）,3（50%）,3（100%）;epithelial cell type 5（22.7%）,5（26.3%）,3（50%）,0;mixed type 2（9.1%）,2（10.5%）,0,0.47 cases were CD117 positive（94%）,45 cases were DOG-1 positive（90%）,40 cases were CD34 positive（80%）,12 cases were CD117 and/or CD34 negative（24%）,1 case was CD34,CD117,DOG-1 tri-negative（2%）.13 cases were SMA positive（26%）,6 cases were S-100 positive（12%）.ConclusionSpindle cell type is the common type of GIST,epithelial type and mixed type take second place,but the percentage is not identical given the different diseased regions.CD117,DOG-1,CD34 are highly expressed in GIST.By combining SMA,S-100 and histopathological morphology,most GIST can be definitely diagnosed.

关 键 词：胃肠间质瘤 免疫组织化学 CD117 DOG-1 CD34 

分 类 号：R735.2[医药卫生—肿瘤]