胃肠道间叶源性肿瘤病理及免疫组化研究

目的:研究胃肠道间叶源性肿瘤的病理形态特点及免疫组化表型,讨论肿瘤的来源,进而提高对该类肿瘤的认识。方法:对60例胃肠道间叶源性肿瘤进行回顾性分析,应用免疫组化SP法检测CD117,CD34,Vimetin,S-100,SMA,Bcl-2的表达。结果:60例胃肠道间叶源性肿瘤中胃肠道间质瘤占85%,平滑肌肿瘤占8.33%,神经鞘瘤占1.67。其中51例胃肠道间质瘤中CD117的表达率为90.19%,CD34的表达率80.39%,Vimetin的表达率86.27%,Bcl-2的表达率为74.5%(38例),S-100的表达率11.76%。结论:胃肠道间叶源性肿瘤以胃肠道间质瘤最多见。对胃肠道间叶源性肿瘤的诊断不能完全靠光镜,必须结合免疫组化,才能做正确诊断。对胃肠道间叶源性肿瘤的诊断最好联合使用一组免疫组化抗体,其中CD117和CD34是诊断胃肠道间质瘤最敏感而有效的免疫组化标记。

Study on the immunohistochemical and pathological characteristics of gastrointestinal mesenchymal tumors

Objective To study the pathological and immunohistochemical characteristics of gastrointestinal mesenchymal tumors. Methods The expressions of CD117, CD34, Vimentin, S-100, SMA and Bcl-2 were detected in 60 cases of gastrointestinal mesenchymal tumors tissues with immunohistochemistry. Results Fifty-one cases were gastrointestinal stromal tumors, 5 cases were leiomyomas and 1 case was schwannomas in 60 cases of gastrointestinal mesenchymal tumors. As to immunohistochemical reaction to GIST, the positive rate of CD117 was 90.19%, of CD34 was 80.39%, of Vimentin was 86.27%, of Bcl-2 was 74.50%, of SMA was 29.41%,and of S-100 was 11.76%.Conclusion Gastrointestinal stromal tumor is the most common mersenchymal tumor in gastrointestinal tract. To diagnose the gastrointestinal stromal tumors not only depends on microscope, but also depends on immunohistochemistry. CD117 and CD34 may be helpful in the diagnosis of gastrointestinal stromal tumors.