胃肠道间质瘤35例的临床与病理

目的　提高对胃肠道间质瘤 (GISTs)的临床与病理方面的认识。方法　收集我院 1997年 2月至 2 0 0 3年 1月 3 5例手术治疗的胃肠道间质瘤 ,对其临床、病理和治疗方法进行分析。结果　GISTs成人多见 ,≥ 40岁占 85 .7%( 3 0 /3 5 )。男女发病无明显差别。发生于胃和小肠者占 94.3 %( 3 3 /3 5 ) ,临床以消化道出血、疼痛多见 ;光镜下为梭形细胞和上皮样细胞两种成分 ,免疫标记CD3 4 、CD1 1 7在GISTs中有较高表达 ,分别为 77.8%和 72 .7%。结论　术前明确诊断较困难 ,常规组织学与平滑肌 (肉 )瘤、神经鞘瘤有时易混淆 ,免疫组化有助于明确诊断 ,手术切除肿瘤为主要治疗方法。

Clinical and pathological features of patients with gastrointestinal stromal tumors:A analysis of 35 cases

Objective To investigate the clinical and pathollgical features of patients with gastrointestinal stromal tumors. Methods The data of 35 patients with GISTs were analyzed in this article. Results Most of the patients with GISTs were adult, the patients more than 40 years old accounted for 85.7%(30/35). The tumors originated from the stomach and small intestines accounted for 94.3%(33/35). Castrointestinal hemorrhage and pain occurred frequently as the main clinical manifestations. Spindle and epithelioid cells were the two principal compositions observed under light microscope. Positive rates of CD 34 and CD 117 in GISTs were 77.8% and 72.7% respectively. Conclusion GISTs arethe most common stromal tumors of gastrointestinal tract. It is often difficultto make diagnosis before operation. Some of them were difficult to differetiatefrom leiomyomas and schwannomas without immunohistochemical aids. Complete gross surgical resection is presently the only means of cure for GISTs.