胃肠间质瘤47例临床分析

目的总结胃肠间质瘤的临床病理和免疫组织化学（免疫组化）特征，探讨其诊断和治疗，并评价预后。方法对2002年1月-2007年3月5年期间收治的47例胃肠间质瘤病人的临床资料进行回顾性分析，并完成随访。结果47例病人中CD117阳性40例（85．1％），CD34阳性39例（83．0％），S-100阳性10例（21．3％），平滑肌肌动蛋白SMA阳性3例（6．4％），结蛋白desmin全部阴性。结论CT结合内镜检查可提高诊断率，最终确诊主要依靠病理及免疫组化，CD117是诊断GIST的重要标记物，手术完整切除肿瘤效果满意．恶性GIST宜行较大范围的切除术，必要时须行联合脏器切除。

Clinical analysis of 47 cases of gastrointestinal stromal tumors

Objective To investigate the clinicalpathological characteristics and analyze the diagnosis therapy,and prognosis of gastrointestinal stromal tumors （GISTs）. Methods forty seven cases, admitted to our hospital from Jan. 2002 to Mar. 2007, were detected by Envision immunohistochemical method and diagnosed as GISTs. Their pathological features, immunohistochemical phenotypes, clinical manifestations and imaging findings were analyzed. The surgical outcomes were analyzed retrospectively. Results Of the 47 GISTs, 40 cases were positive for CD117 （40/47, 85.1%）, 39 cases were positive for CD34 （39/47,83%）, 10 cases were positive for S-100 （10/47, 21.3%）, 3 cases were positive for SMA （3/47, 6.4%）, 0 cases were positive for desmin. Conclusions CT plus endoscopy examination can improve the accuracy of diagnoss of GIST. The ultimate diagnosis of GIST depends on pathological observation and immunohistochemical study. CD117 is a sensitive marker for the diagnosis of GIST. Surgical resection is the first choice for treating GIST. Extended resection, even combined resection of involved organs, is required for malignant GIST.