胃间质瘤的内镜、病理和免疫组织化学特征

目的探讨胃间质瘤的内镜、病理和免疫组织化学特征。方法对外科手术切除的胃肿瘤标本用显微镜作初步观察，拟诊为间叶性肿瘤者再检查CD117、CD34、波形蛋白、结蛋白等抗原标记物。复习胃间质瘤患者术前临床资料，了解其内镜和临床特征。结果33例胃间叶肿瘤中，间质瘤28例。该28例中良性9例，交界性11例，恶性8例。胃镜下多呈黏膜下显著隆起性病变，10例表面存在深凹陷性溃疡。病灶位于胃底15例，胃体10例，胃窦3例。显微镜下细胞主要呈梭型和上皮细胞型，细胞排列呈栅栏状、旋涡状。免疫组织化学显示肿瘤组织中抗原表达阳性率为：CD117 100％(28／28)、CD117 100％(28／28)、波形蛋白100％(17／17)，而结蛋白无表达，S-100蛋白表达率仅为18．2％(4／22)。结论胃间质瘤是最常见的间叶性肿瘤，CD117、CD34可作为诊断胃间质细胞瘤的免疫标记物。

Study on the endoscopic, pathologic and immunohistochemical characteristics of gastric stromal tumor

Objective To study on the endoscopic, pathologic and immunohistochemical characteristics of gastric stromal tumor. Methods The gastric tumor samples were studied with light microscopy, and in those suspected of mesenchymal tumor the expression of CD11734, CD34 , vimentin, desmin, S-100 etc. were further determined with SP method. The clinical, pathological and endoscopic characteristics were reviewed. Results Twenty-eight cases of mesenchymal cell tumor were diagnosed as stromal tumor and enrolled in this study, with 9 benign, 11 borderline, and 8 malignant cases. Endoscopically, the gastric stromal tumors showed submucosal protuberant lesions, and were situated in fundus (15 cases), body (10 cases) and an-trum (3 cases). Deep concave ulcer presented on tumor surface in 10 patients. Histology revealed the typical stromal tumor features with cell in spindle and/or epithelia shape and arranged in fence-like or spiral forms. All cases were positive for CD117 CD34 , vimentin when assessed, but 28 cases were negative for desmin and 22 cases (18. 2% ) for S-100. Conclusion The gastric stromal tumors were the most common mesenchymal tumors. Microscopically, the tumors were composed of spindle or epithelioid cells. CD117 and CD34 can be used as immune markers to diagnose gastric stromal tumor.