胃肠道平滑肌肿瘤的病理改变与预后的关系及其组织起源探讨

对73例胃肠道平滑肌肿瘤的病理改变与预后的关系的研究结果表明:核分裂相数是估计该肿瘤良、恶性程度及预后的最好指标。0个/10HPF为良性,1～9个/10HPF为低度恶性,≥10个/10HPF为高度恶性;在易查见核分裂相的肿瘤中,直径>6cm者较<6cm者预后差。免疫组化染色,结蛋白阳性率为43.83％。电镜观察,5例中3例查见向平滑肌分化的证据。文内还对该肿瘤的组织起源进行了探讨。

Smooth Muscle Tumors of Gastrointestinal Tract: A Study on Correlation between Pathology and Prognosis and Histogenesis

Seventy three cases of gastrointestin-al smooth muscle tumors (GISMT) werecollected and their correlation betweenpathology and prognosis and their histo-genesis was studied. microscopically, thefollowing parameters were evaluated:1.celluarity; 2. grade of differentiation; 3.nuclear pleomorphism; 4.mitotic rate/10HPF.All cases were followed up, but fromonly 47 information was elicited.To studythe histogenesis, the technique of immuno-histochemical staining to desmin, S--100protein was used in all the cases and fivewere examined by EM. The results showedthat the mitotic rate was the most im-portant and reliable pathological parameterused to differentiate between benign andmalignant tumors, and to evaluate theprognosis of a given tumor;in the caseswhich showed active mitosis. tumor sizewas important to evaluate the prognosis;the other histologic parameters or less.if any,significance in evaluation of prog-nosis.The authors supported the hypoth-esis that GISMT might mainly be derivedfrom primary mesenchymal cells potentiated with smooth muscle cells diff eren-tiation.The hypothesis that GISMT arederived from nerve tissue waits forfurther evidence.