86例胃肠间质瘤的生物学特点与病理特征的关系分析

目的探讨胃肠道间质瘤（Gastricintestinaltumor，GIST）的临床表现与病理特点的关系。方法回顾分析手术切除后病理诊断为GIST的86例患者的临床表现及病理特征。结果86例切除的胃肠道间质瘤中10例为良性（包括7例潜在恶性），肿物平均直径2．0em，16例为低度恶性，肿物平均直径2．9cm，60例为高度恶性，肿物平均直径8．6cm。其中53．5％（49／86）来源于胃，27．4％（23／86）来源于小肠，4．7％（4／86）来源于大肠，11．6％（10／86）来源于网膜、腹腔。良性组肿瘤无明显出血、坏死，细胞无异型性，核分裂少见。恶性组肿瘤可见出血、坏死，细胞异型性明显，核分裂多见。免疫组化指标测定CD117阳性80例，占93．0％，CD34阳性68例，占79．1％，SMA阳性13例，占15．1％，S100阳性4例，占4．7％。结论GIST主要发生在胃、肠道和腹腔，C117和CD34阳性是诊断GIST最有价值的免疫标记物。GIST的恶性程度与肿瘤的大小、核分裂数和发病部位密切相关。

The relationship of clinical symptoms and pathological characteristics of 86 cases of gastrointestinal stromal tumor

Objective To explore the histogenesis,immunohistochemical and clinic pathological characteristics of gastrointestinal stromal tumor.Methods The postoperative pathological findings of 86 cases of gastrointestinal stromal tumor were analyzed retrospectively.Results The 86 cases of GIST were consisted of 10 benign cases,16 low-degree malignant cases and 60 high-degree malignant cases.53.5%(49/86) of which were from stomach,27.4%(23/86) from small intestine,4.7 %(4/86) from colon and 11.6%(10/86)from mesenteric.Innocuousness tumor group had no manifest bleeding and necrosis.Cells had no heteromorphism and less caryocinesia.Malignacy tumor group were abundance of cellulars and haemorrhage,necrosis,heteromorphism,caryocinesia were manifest.The positive rate of CD117(80 cases) was 93.0%,the positive rate of CD34(68 cases) was 79.1%,the positive of SMA( 13 cases) was 15.1% and the positive rate of S100(4 cases) was 4.7%.Conclusion Pathologic features are different between benign and malignant gastrointestinal stromal tumor,and it is necessary to use immunohistochemical marker for differentiation the diagnosis,particurly CD117 and CD34.There is strong relationship between the GIST malignancy and its size,mitomic index and anatomic location.