胃肠道间质细胞瘤临床病理与免疫组化研究

目的　探讨胃肠间质瘤 (GISTs)的临床病理和免疫组化特征 ,为其诊断提供参考指标。方法　对 3 5例GISTs进行病理形态学观察 ,并采用免疫组化染色检测其CD1 1 7、CD3 4、vimentin、SMA和S-1 0 0蛋白表达检测。结果　 3 5例GISTs中 ,良性 1 6例 ,恶性 1 7例 ,潜在恶性 2例 ,主要由梭形细胞和上皮样细胞构成。免疫组化vimentin、CD3 4、CD1 1 7肿瘤细胞显示明显阳性 ,阳性率分别为 1 0 0 %、88 6%、60 0 % ,SMA和S -1 0 0蛋白呈散在细胞阳性 ,阳性率分别为 3 4 3 %和 6 1 %。结论　GISTs是胃肠道最常见的间质肿瘤 ,HE染色下形态与平滑肌肿瘤和神经源性肿瘤较相似 ,免疫组化染色对其诊断和鉴别诊断具有重要作用 ,CD1 1 7特异性较高 ,CD3 4敏感性较高

Clinicopathological and immunohistochemical study of gastrointestinal stromal tumors

Objective To investigate clinicopathologic and immunohistochemical characteristics of gastrointestinal stromal tumors(GISTs). Methods The morphologic characteristics were observed by light microscopy and the expression of CD117, CD34, vimentin, SMA and S-100 protein were detected by immunohistochemical examination in 35 cases of GISTs. Results Out of 35 GISTs, 16 cases were benign, 17 cases malignant, 2 cases latently malignant. Histological GISTs vary from cellular spindle cell tumors to epithelioid ones. The tumor cells were positive for vimentin, CD34 and CD117, and the positive rate was 100%, 88.6% and 60.0%, respectively, and scattering cells were positive for SMA, S-100 protein, and the positive rate was 34.3%, 6.1%, respectively. Conclusions GISTs is the most common stromal tumors of gastrointestinal tract, its morphological changes were similar to smooth muscle tumor and neurogenic tumour in HE stain. Immunohistochemical stains play an important role in the diagnosis and differentiated diagnosis of GISTs, whereas CD117 is relatively highly specific and CD34 is relatively highly sensitive.