胃肠道间质瘤的临床病理和免疫组织化学特征

目的探讨胃肠道间质瘤(GIST)的临床病理以及免疫组织化学特征。方法回顾性分析72例GIST患者的临床资料。结果 72例GIST患者的肿瘤部位为:25例(34.7%)胃部,24例(33.3%)小肠,23例(31.9%)其他部位。镜下显示主型为梭形细胞68例(94.4%),主型为上皮样细胞1例(1.4%),混合细胞型3例(4.2%)。免疫组化检查显示,71例(98.6%)CD117阳性,52例(72.2%)CD34阳性,22例(30.6%)SMA阳性,1例(1.4%)Desmin阳性,6例(8.3%)S-100阳性。结论 GIST的发病部位较多,组织形态学表现复杂,联合应用免疫组化检查有助于临床诊断与鉴别。     

胃肠道间质瘤25例临床病理及免疫组化分析

目的　探讨胃肠道间质瘤 (GIST)的临床表现、免疫组织化学特点及预后因子。方法　 1998～ 2 0 0 3年同济大学附属东方医院用病理、免疫组化确诊 2 5例GIST ,结合临床资料 ,对其生物学行为进行分析。结果　发生于食管 1例 ,胃 11例 ,十二指肠 4例 ,空肠 8例 ,直肠 1例。镜下观察 ,梭形细胞 2 3例 ,上皮样细胞 2例。免疫组化CD117、CD34、Vim、SMA、S - 10 0和Des的阳性率分别为 88%、80 %、88%、2 0 %、2 0 %和 0 %。根据肿瘤大小及核分裂象将 2 5例病人分为良性组 2例、低度危险组 11例、中度危险组 5例及高度危险组 7例。随访显示低度、中度、高度危险组中出现囊性变的比率分别为 0、6 0 %、10 0 %。 3组中的病死率分别为 0、2 0 .0 %、4 2 . 9%。结论　GIST好发于中老年 ,男女发生率相等。肿瘤细胞形态多为梭形 ,免疫组织化学为CD117、CD34、Vim阳性。直径大于 5cm、核分裂象大于 5 / 5 0HPF(高倍显微镜 )及囊性变可作为GIST预后差的预测因子。     

盆腔囊性间质瘤病理学观察

目的 探讨盆腔囊性间质瘤的病理学特征、免疫学表型.方法 收集2例盆腔囊性间质瘤患者的临床资料,并对其手术切除标本进行大体、组织学形态及免疫组织化学染色观察.结果 例1肿瘤为位于直肠与乙状结肠系膜交界处的一囊性肿物,最大直径18.5 cm;例2肿瘤为位于距回盲部150 cm的回肠浆膜处的一囊性肿物,最大直径12 cm.镜下可见,例1肿瘤无包膜,例2有部分包膜;例1、例2瘤细胞呈漩涡状、束状排列,瘤细胞梭形及短梭形或椭圆形,胞质嗜酸性,核梭形或椭圆形,核仁明显,例1未见核分裂,例2核分裂计数2/10 HPF,可见出血、坏死,例2伴有丰富的黏液样基质.免疫组织化学染色,例1、例2瘤细胞CD117、波形蛋白Vimentin弥漫阳性,例1平滑肌肌动蛋白SMA弥漫强阳性.结论 盆腔囊性间质瘤病理学特征为囊性肿物,无包膜或有部分包膜,肿瘤细胞呈漩涡状、束状排列,瘤细胞梭形及短梭形或椭圆形,胞质嗜酸性,核梭形或椭圆形,核仁明显;免疫学表型肿瘤细胞CD117阳性.     

胃肠道间质瘤的多层螺旋CT表现及病理特点分析

目的 为进一步提高胃肠道间质瘤（GIST）的诊治水平提供依据.方法 回顾性分析经病理证实的15例GIST患者的多层螺旋CT表现和病理检查结果.结果 多层螺旋CT检查示肿瘤位于食管1例、胃10例、小肠3例、结肠1例;肿块最大径3～ 15 cm;8例为腔外生长,4例为腔内生长,3例混合性生长;大多数密度不均匀,少数有囊变或坏死,增强扫描肿瘤实质部分大多中等至明显强化,静脉期持续强化.病理检查光镜下见肿瘤为梭形细胞型9例,上皮样细胞型4例,梭形及上皮样细胞混合型2例.免疫组织化学特征：CD117阳性13例（86.7％）,CD34阳性10例（66.7％）,Vimentin阳性14例（93.3％）,SMA阳性7例（46.7％）.结论 多层螺旋CT检查能准确显示GIST的肿瘤部位、形态、大小,确诊依赖病理和免疫组织化学检查.     

胃肠道间质瘤的诊断及治疗

对25例胃肠道间质瘤(GIST)患者的临床、病理及随访资料作回顾性分析.瘤组织镜下均找到梭形细胞,CD117阳性22例、CD34阳性14例、平滑肌肌动蛋白(SMA)阳性2例、S-100阳性3例;肿瘤恶性潜能分级及是否手术根治与预后密切相关.认为内镜和影像学检查是发现GIST的主要手段,采用Flecther恶性潜能分级方法来判断GIST的生物学行为和预后是合理、可行的;手术是确诊和治疗GIST的主要方法.     

胃肠道间质瘤的概念和诊治方法的演变

介绍胃肠道间质瘤(GIST)的组织学和分子生物学进展。新的GIST的诊断定义是表达KIT蛋白(CD117)、富于梭形细胞或上皮样细胞的胃肠道间叶性肿瘤。除手术外,近3年来酪氨酸激酶抑制剂伊马替尼治疗不能手术的晚期GIST患者取得较好效果。     

胃肠道间质瘤的概念和诊治方法的演变

介绍胃肠道间质瘤(GIST)的组织学和分子生物学进展。新的GIST的诊断定义是表达KIT蛋白(CD117)、富于梭形细胞或上皮样细胞的胃肠道间叶性肿瘤。除手术外，近3年来酪氨酸激酶抑制剂伊马替尼治疗不能手术的晚期GIST患者取得较好效果。     

肠系膜巨大间质瘤自发破裂出血1例并文献复习

正胃肠道间质瘤(GIST)是一种免疫表型以CD117阳性表达,遗传上以c-kit基因突变为特征,组织学上以富含梭形细胞和上皮样细胞为特征的胃肠道间叶源性肿瘤。GIST可发生于消化道任何部位,其中以胃最常见,约占全部GIST的60%～     

食管梭形细胞肿瘤的临床病理和免疫组织化学特征

目的 探讨食管梭形细胞肿瘤的临床病理表现和免疫组织化学特征以及免疫组织化学染色在食管梭形细胞肿瘤中的诊断和鉴别诊断意义.方法 68例内镜及手术切除标本常规石蜡切片和免疫组织化学EnVision两步法染色.结果 光镜下全部病例组织形态均呈平滑肌瘤表现,免疫组织化学染色显示程度不等的SMA阳性,64例CD 117阴性,4例局部阳性,MCT阳性细胞存在于平滑肌瘤中而间质瘤内缺乏.结论 食管梭形细胞肿瘤中以平滑肌瘤最为常见,缺乏典型间质瘤的免疫表型.CD 117、SMA和MCT的染色有助于平滑肌瘤与间质瘤的鉴别诊断.     

胃肠道间质瘤的病理改变、免疫组化表达与肿瘤风险度的关系

目的：探讨胃肠道间质瘤（ GIST）的病理改变、免疫组化表达与肿瘤风险度的关系。方法选择33例GIST患者手术切除的病理标本,观察肿瘤的病理改变,并行CD117、CD34、SMA、S-100免疫组化标记,对其病理学改变及免疫组化表达结果与肿瘤风险度的关系进行综合分析。结果肿瘤极低度风险6例,低、中度风险20例,高度风险7例;肿瘤风险度越高,肿瘤直径越长（ P＜0．05）。病理类型为梭型细胞型28例,混合细胞型3例,上皮样细胞型2例;不同病理类型的风险度分级不同（P＜0．05）。极低度、低度、中度、高度风险患者的CD117、CD34、SMA、S-100阳性表达率比较均无统计学差异（P均＞0．05）。结论 GIST的病理类型逐步由梭形细胞型向混合细胞型及上皮样细胞型转化;肿瘤病理学形态结合CD117、CD34检测对其诊断具有特异性作用;肿瘤风险分度需根据肿瘤大小及病理类型等综合判断。     

胃肠道间质瘤临床病理免疫组化分析

目的通过检测原癌基因c-kit蛋白（CD117）在胃肠道间质瘤（GISTs）中的表达,探讨CD117在GISTs诊断中的意义。方法收集50例GISTs病例行常规检查及免疫组化染色。标记抗体主要为CD117、CD34 SMA、S100、desmin。结果50例中49例（98％）CD 117阳性,39例（78％）CD34阳性,4例（8％）SMA阳性,2例（4％）S100阳性。其中良性组CD117 12例（12／12）均阳性,交界性组CD117 7例（7／8）阳性。恶性组30例（30／30）CD 117阳性。对照组平滑肌瘤及神经鞘瘤CD117均阴性。结论CD117在GISIs的鉴别诊断中具有重要意义。     

Esophageal mesenchymal tumors： Endoscopy, pathology and immunohistochemistry

AIM： To study the endoscopic, pathological and immunoo histochemical features of esophageal mesenchymal tumors. METHODS： Twenty-nine patients diagnosed as esophageal rnysenchymal tumors by electronic endoscopy and endoscopic ultrasound （EUS） were observed under light microscopes, and all tissues were stained by the immunohistochemical method. The expression of CD117, CD34, SMA and desmin were measured by staining intensity of cells and positive cell ratios. RESULTS： Endoscopically, esophageal gastrointestinal stromal tumors （GISTs） and leiomyomas （LMs） had similar appearances, showing submucosal protuberant lesions. They all showed low echo images originated from the muscularis propria or muscularis mucosa on EUS. Endoscopy and EUS could not exactly differentiate esophageal GISTs from LMs. Microscopically, there were two kinds of cells： spindle cell type and epitheloid cell type in esophageal GISTs. Leiomyomas and leiomyosarcornas were only of spindle cell type. One malignancy was found in five cases of esophageal GISTs, and one malignancy in 24 cases of leiomyomas and leiomyosarcomas. Using Fisher＇s exact method, the differences of malignant lesion proportion were not significant between esophageal LMs and GISTs, 1/5 vs 1/24 （P 〉 0.05）. All cases of esophageal GISTs were positive for CD117, and 3 cases were also positive for CD34. The 24 cases of leiomyomas and leiomyosarcomas were all negative for CD117 and CD34. The differences of positive rates of CD117 and CD34 were significant between esophageal GISTs and LMs, 5/5 vs 0/24, 3/5 vs 0/24 （P 〈 0.005）. All leiomyomas and leiomyosarcomas were positive for SMA, and desmin. Among 5 cases of esophageal GISTs, 2 cases were SMA positive, and 1 case was desmin positive. The differences in positive rates and expression intensity of SMA and desmin were significant between esophageal LMs and GISTs, 24/24 vs 2/5, 24/24 vs 115 （P 〈 0.005）. CONCLUSION： The most common esophageal mesenchymal tumors are leiomyomas, and esophageal GISTs     

Analysis of CD117-negative gastrointestinal stromal tumors

AIM: To identify the gastrointestinal stromal tumors (GISTs) that are negative for CD117 expression by immunohistochemistry and to characterize their malignant potential. METHODS: A total of 108 primary mesenchymal tumors of the gastrointestinal tract were screened to select CD117-negative tumors, from which KIT(exons 9,11,13, and 17) and PDGFRA (exons 10, 12, 14, and 18) were sequenced to identify GISTs. Tumor recurrence and distant metastasis were used as the criteria of malignancy. RESULTS: The result showed that approximately 25% (29/108) of the gastrointestinal mesenchymal tumors were negative for CD117 and approximately 6% (7/108) of the tumors were CD117-negative GISTs. All these CD117-negative tumors had a mutated KIT and a wildtype PDGFRA. All CD117-negative GISTs with mutations at codons 557/558 of KIT had mitotic counts >10/50 high power field, and 75% (3/4) of them showed multiple recurrence or distant metastasis. CONCLUSION: CD117-negative KITmutated GISTs account for approximately 6% of the gastrointestinal mesenchymal tumors. Tumor recurrence or distant metastasis correlates to both the KIT mutations at codons 557/558 and the mitotic counts, but not to the tumor size.     

KIT-negative gastrointestinal stromal tumors with a long term follow-up： A new subgroup does exist

AIMTo investigate the incidence of KIT immunoho-stochemical staining in(GI)stromal tumors(GISTs),and to analyze the clinical manifestations of the tumors and prognostic indicators.METHODSWe retrospectively analyzed 50 cases of Previously diagnosed GISTs.Tissue samples were assessed with KIT(CD117 antigen),CD34,SMA,desmin,S-100,NSE,PCNA,Ki-67,and BCL-2 for immunohistochemical study and pathological characteristics were analyzed for prognostic factors.RESULTSFifteen tumors(30%)were negative in KIT staining.A significant association was observed between gender(male patients14/15)and KIT-negative staining P = 0.003).The patients's mean age was 56.6 years.Tumors developed in stomach(n = 8),small intestine (n = 5),large intestine(n = 1)and oesophagus(n = 1).The mean tumor size was 5.72 cm.The mitotic count ranged from 0-29/50 HPF(mean3.4)and 73% of tumors showed no necrosis.The majority of the tumors(67%)had dual or epithelioid differentiation.Tumors were classified as very low or low risk(n = 7),intermediate risk(n = 5),and high risk(n = 3)groups.Twelve(80%)patients were alive without evidence of residual tumor for an average period of 40.25 mo(12-82 mo);three patients developed metastatic disease to the liver and eventually died within 2-12 mo(median survival8.6 mo).CONCLUSIONA small subgroup of GISTs fulfils the clinical and morphological criteria of these tumors,and lacks KIT expression.These tumors predominantly developed in the stomach,being dual or epithelioid in morphology,which are classified as low risk tumors and presented a better survival status than KIT-positive tumors.The ability to diagnose GISTs still depends on immunohistochemical staining but the research should extend in gene mutations.     

Clinical manifestations and prognostic factors in patients with gastrointestinal stromal tumors

AIM: To investigate the incidence of CD117-positive immunohistochemical staining in previously diagnosed gastrointestinal (GI) tract stromal tumors (GIST) and to analyze the tumors‘ dinical manifestations and prognostic factors. METHODS: We retrospectively reviewed 91 cases with a previous diagnosis of GI stromal tumor, leiomyoma, or leiomyosarcoma. Tissue samples were assessed with CDl17, CD34, SMA and Sl00 immunohistochemical staining. Clinical and pathological characteristics were analyzed for prognostic factors. RESULTS: CDl17 was positive in 81 (89%) of 91 tissuesamples. There were 59 cases (72.8%) positive for CD34, 13 (16%) positive for SMA, and 12 (14.8%) positive for S100. There was no gender difference in patients with CD117-positive GIST. Their mean age was 65 years. There were 44 (54%) tumors located in the stomach and 29 (36%) in the small intestine. The most frequent presenting symptoms were abdominal pain and GI bleeding. The mean tumor size was 7.5±5.7 cm. There were 35 cases (43.2%) with tumors >5 cm. The tumor size correlated significantly with tumor mitotic count and resectability. Tumor size, mitotic count, and resectability correlated significantly with tumor recurrence and survival. There was recurrent disease in 39% of our patients, and their mean survival after recurrence was 16.6 months. Most recurrences were at the primary site or metastatic to the liver. Twenty-six percent of our patients died of their disease.CONCLUSION: Traditional histologic criteria are not specific enough to diagnose GIST. This diagnosis must be confirmed with CDl17 immunohistochemical staining. Prognosis is dependent on tumor size, mitotic count, and resectability.     

Gastrointestinal stromal tumors: clinical, pathologic features and effectiveness of new diagnostic criteria]

BACKGROUND/AIMS: The effective and reproducible diagnostic parameters for differentiating benign from malignant gastrointestinal stromal tumors (GISTs) are still not clear. In this study, GISTs were diagnosed and classified by immunohistochemistry and their clinical and pathologic features were investigated. GISTs were re-evaluated by Amin's and NIH's criteria, and prognostic relevance of these two criteria were compared. METHODS: Fifty cases of gastrointestinal mesenchymal tumor diagnosed from May 1990 to February 2000, were evaluated by immunohistochemical staining for CD117, CD34, smooth muscle actin, and S-100 protein. GISTs were diagnosed according to Amin's and NIH's criteria. The relationship between the prognosis and diagnosis based on Amin's or NIH's classification were analyzed. RESULTS: Thirty cases of gastrointestinal mesenchymal tumors were diagnosed as GISTs. The stomach (40%) and small bowel (40%) were the most common origin for GISTs. Immunophenotypically, null, myoid, neural, combined type were 70.0%, 10.0%, 16.7% and 3.3%, respectively. Seven cases showed metastasis and one case showed recurrence. According to Amin's criteria, 5 benign, 8 borderline and 17 malignant tumors were diagnosed. The NIH's criteria showed 2 very low risk, 6 low risk, 7 intermediate risk, and 15 high risk tumors. Metastasis or recurrence of GISTs had no significant relationship with malignancy according to Amin's criteria (p=0.4069) but had significant correlation with high risk tumor based on NIH's criteria. (p=0.0352). CONCLUSIONS: GISTs showing local invasion, distant metastasis or recurrence were related with high risk tumors based on NIH's criteria. NIH's criteria might be better reliable scheme than Amin's for predicting the prognosis of GISTs.     

胃肠道间质瘤的临床诊治及病理免疫组化分析

目的 探讨胃肠道间质瘤（GISTs）的临床诊治方法及病理免疫组化特征。方法 对我院2003年8月至2006年6月经手术及病理证实为GISTs的26例病例作回顾性分析。用免疫组化SP法检测CD117、CD34、Vimentin、desmin及S-100等5种抗体的表达情况。结果 26例GISTs中,胃12例,占46．2％;小肠10例,占38．5％;食管1例,占3．8％;直肠2例,占7．7％;肠系膜1例,占3．8％。其中良性9例（9／26）,低度恶性9例（9／26）,恶性8例（8／26）。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〈0．05）,良、恶性间质瘤的大小比较差异有显著性（P〈0．05）。术前诊断GISTs仅3例,术前诊断率为11．5％,多误诊为胃癌、平滑肌瘤等。CD117、CD34、Vimentin、desmin及S-100阳性率分别为92％（24／26）、88％（23／26）、100％（26／26）、4％（1／26）、12％（3／26）。结论 GISTs可发生于任何年龄,但多见于50岁以上的中老年人。GISTs可发生在从食管到直肠的消化道的任何部位,主要发生在胃和小肠,肿瘤发生部位和大小与肿瘤良恶性密切相关。GISTs术前诊断较困难,CD117和CD34在间质瘤的诊断中具有重要价值。     

下消化道间叶源性肿瘤CT仿真内镜与病理的对照研究

目的 观察下消化道问叶源性肿瘤(GIMTs)的病理及免疫组化特点,对照研究其与CT仿真内镜(CTVE)诊断之间的关系,评价CTVE在下消化道GIMTs中的诊断价值.方法 收集74例下消化道GIMTs患者的手术病理标本,采用光镜观察其病理特点及良恶性状况,免疫组化法检测其CD117、CD34、α-平滑肌抗体(SMA)及S-100蛋白的表达,并与术前CTVE判定的病变部位及良恶性结果进行对照研究.结果 经病理及免疫组化检查,40例(54.1%)诊断为胃肠道间质瘤(GIST),其中恶性间质瘤16例(40%);33例(44.6%)诊断为平滑肌瘤;1例(1.4%)诊断为神经鞘瘤.发病部位位于空肠33例,回肠21例,大肠20例.免疫组化:CD117阳性38例,占51.4%;CD34阳性27例,占36.5%;SMA阳性46例,占62.2%,S-100阳性1例(1.4%).CTVE对病变部位准确定位69例(93.2%).其中大肠准确定位18例,符合率90.0%;空回肠准确定位51例,符合率94.4%.CTVE判断良恶性GIST的敏感性为84.2%,特异性为85.7%.结论 GIST是下消化道最常见的GIMTs,发病部位以小肠居多.CTVE能准确显示肿瘤的部位、形态、大小,可术前准确定位GIMTs,对其良恶性判断具有较高的敏感性和特异性,可为术前制定合理手术方案和治疗策略提供重要依据.     

下消化道间叶源性肿瘤CT仿真内镜与病理的对照研究

目的 观察下消化道问叶源性肿瘤(GIMTs)的病理及免疫组化特点,对照研究其与CT仿真内镜(CTVE)诊断之间的关系,评价CTVE在下消化道GIMTs中的诊断价值.方法 收集74例下消化道GIMTs患者的手术病理标本,采用光镜观察其病理特点及良恶性状况,免疫组化法检测其CD117、CD34、α-平滑肌抗体(SMA)及S-100蛋白的表达,并与术前CTVE判定的病变部位及良恶性结果进行对照研究.结果 经病理及免疫组化检查,40例(54.1%)诊断为胃肠道间质瘤(GIST),其中恶性间质瘤16例(40%);33例(44.6%)诊断为平滑肌瘤;1例(1.4%)诊断为神经鞘瘤.发病部位位于空肠33例,回肠21例,大肠20例.免疫组化:CD117阳性38例,占51.4%;CD34阳性27例,占36.5%;SMA阳性46例,占62.2%,S-100阳性1例(1.4%).CTVE对病变部位准确定位69例(93.2%).其中大肠准确定位18例,符合率90.0%;空回肠准确定位51例,符合率94.4%.CTVE判断良恶性GIST的敏感性为84.2%,特异性为85.7%.结论 GIST是下消化道最常见的GIMTs,发病部位以小肠居多.CTVE能准确显示肿瘤的部位、形态、大小,可术前准确定位GIMTs,对其良恶性判断具有较高的敏感性和特异性,可为术前制定合理手术方案和治疗策略提供重要依据.     

下消化道间叶源性肿瘤CT仿真内镜与病理的对照研究

目的 观察下消化道问叶源性肿瘤(GIMTs)的病理及免疫组化特点,对照研究其与CT仿真内镜(CTVE)诊断之间的关系,评价CTVE在下消化道GIMTs中的诊断价值.方法 收集74例下消化道GIMTs患者的手术病理标本,采用光镜观察其病理特点及良恶性状况,免疫组化法检测其CD117、CD34、α-平滑肌抗体(SMA)及S-100蛋白的表达,并与术前CTVE判定的病变部位及良恶性结果进行对照研究.结果 经病理及免疫组化检查,40例(54.1%)诊断为胃肠道间质瘤(GIST),其中恶性间质瘤16例(40%);33例(44.6%)诊断为平滑肌瘤;1例(1.4%)诊断为神经鞘瘤.发病部位位于空肠33例,回肠21例,大肠20例.免疫组化:CD117阳性38例,占51.4%;CD34阳性27例,占36.5%;SMA阳性46例,占62.2%,S-100阳性1例(1.4%).CTVE对病变部位准确定位69例(93.2%).其中大肠准确定位18例,符合率90.0%;空回肠准确定位51例,符合率94.4%.CTVE判断良恶性GIST的敏感性为84.2%,特异性为85.7%.结论 GIST是下消化道最常见的GIMTs,发病部位以小肠居多.CTVE能准确显示肿瘤的部位、形态、大小,可术前准确定位GIMTs,对其良恶性判断具有较高的敏感性和特异性,可为术前制定合理手术方案和治疗策略提供重要依据.

Abstract：

Objective To study the pathological and immunohistochemical features of alimentary tract mesenchymal tumors and compare with computed tomographic virtue endoscopy (CTVE) imaging technology to evaluate the diagnostic value of CTVE in alimentary tract mesenchymal tumors. Methods Seventy-four pathological specimens of alimentary tract mesenchymal tumors were collected. The pathological features and the expression of CD117, CD34, SMA and S-100 were observed by immunohistochemical method with light microscope. The pathological types and characteristics were determined by pathologists and compared with CTVE imaging technology. Results In the 74 cases of alimentary tract mesenchymal tumors,40 cases were diagnosed as stromal tumor with pathological and immunohistochemical methods (54. 1%).Sixteen of them were malignant, accounting for 40% of the stromal tumor while 33 cases were diagnosed as leiomyoma(44. 6%)and 1 case as schwannoma(1.4%) . In the 74 GIMTs cases ,33 were jejunum GIMTs,21 were ileum GIMTs and 20 were large intestine GIMTs. Immunohistochemistry assay in the 74 GIMTs cases showed that 51.4% GIMTs were positive for CD117, approximately 36. 5% were positive for CD34 , 62.2% were positive for smooth-muscle actin (SMA) and 1. 4% were positive for S-100 protein. In the 74 GIMTs cases,69 cases were diagnosed right in the accuracy for location with CTVE(93. 2%) with 51 cases in small intestinal (94. 4%) and 18 cases in large intestinal (90. 0%). The sensitivity and the specificity of CTVE to distinguish benign from malignant stromal tumors by CTVE characteristics were 84. 2% and 85. 7%respectively. Conclusions GIST is common in GIMTs and is often originated from the small intestinal. The immunohistochemistry has great value in diagnosing alimentary tract mesenchymal tumors. The CTVE imaging technology also has great value in diagnosing alimentary tract mesenchymal tumors which can show the localization, shape size and artery of the tumor clearly. The diagnostic sensitivity and specificity of CTVE are high to distinguish benign from malignant alimentary tract GISTs. CTVE plays an important role in guiding the clinical management of GISTs.