胃肠道间质瘤的临床病理及免疫组化观察

目的　观察胃肠道间质瘤 (GIST)的临床病理及免疫组化特征 ,探讨其诊断标准。方法　对 85例胃肠道间质瘤进行形态学观察分析 ,用免疫组化 (S -P)法检测CD 117、CD 3 4、Vim、SMA及S 10 0蛋白。结果　 81.18%的胃肠道间质瘤发生于胃和小肠。瘤细胞以梭形细胞和 (或 )上皮样细胞为主 ,呈弥散状、栅栏状、编织状排列 ,瘤细胞可形成较特征的团巢样结构。CD 117和CD 3 4的阳性率分别为 78.82 %和 87.0 5 % ,部分病例伴有SMA和 (或 )S 10 0蛋白的局灶性弱阳性。结论　胃肠道间质瘤的病理形态存在一定的特征 ,是胃肠道最常见的非上皮性肿瘤 ,缺乏定向分化 ;CD117、CD 3 4免疫标记对GIST的诊断有意义

Clinicopathological and immunohistochemical observation of gastrointestinal stromal tumors

Objective To investigate the clinicopathological and immunohistochemical feature of gastrointestinal stromal tumors (GIST)and discuss their diagnostic criteria. Methods Light microscopy was used to observe the morphologic feature of 85 cases with GIST. S-P immunohistochemical assays of CD 117?CD 34?Vim?SMA?S 100 were performed in all cases. Results 81.18% of GISIs was located at stomach and intestine in 47 cases. The neoplastic cells of GIST were spindle, epithelioid or both in different proportion. The histological spectrum included interlacing fascides,diffuse sheets, storiform and palisading pattern. The formationof cellclusters was rather specical. The positive rates of CD 117 and CD 34 were 78.82%, 87.05%, respectively. A few of GISTs were SMA and/or S100 protein meak positive, usually in focal areas. Conclusion The characteristic histological features exist in GIST, which have no evidence of directional differentiation, constitute the largest category of nonepithelial neoplasms of gastrointestinal tract. The detection of CD 117 and CD 34 is helpful forthe diagnosis of GIST.