胃肠道间质瘤43例临床病理及免疫组化特点

目的:探讨胃肠道间质瘤(gastroin-testinalstromaltumors,GISTs)的组织学起源、病理特点及合理的外科治疗。方法:回顾分析43例经手术治疗的GISTs患者的临床病理资料;免疫组织化学方法检测CD117、CD34、HHF35和S-100的表达情况。结果:免疫组织化学阳性表达率CD117为95·3%(41/43),CD34为74·4%(32/43)。良性、潜在恶性和恶性组之间在肿瘤直径大小(P=0·000)、核分裂相数(P=0·000)、复发/转移率(P=0·016)及CD117阳性率(P=0·021)上的差异有统计学意义。结论:CD117及CD34对GISTs的诊断和治疗具有重要意义。支持将肿瘤直径大小、核分裂相数、复发/转移率及CD117阳性率作为间质瘤恶性潜能的参考指标。核分裂相数多及CD117阳性提示恶性度较高。大多数胃肠道外间质瘤为高恶性潜能。

Clinicopathologic and immunohistochemical study on 43 cases of gastrointestinal stromal tumors

OBJECTIVE:To explore the histogenesis, surgical treatment and pathological characteristics of gastrointestinal stromal tumors (GISTs). METHODS: The clinicopathological data of operated 43 patients with GISTs were analyzed retrospectively. Expressions of CD_ 117 , CD_ 34 , HHF35 and S-100 were determined by the immunohistochemical methods. RESULTS: Expressions of CD_ 117 and CD_ 34 were 95.3%(41/43) and 74.4%( 32/43 ). There were significant differences in tumour diameter (P=0.000), mitotic activity (P=0.000), recourrance/metastasis ratio (P=0.016) and positive ratio of CD_ 117 (P=0.021) among benign, potential malignant and malignant GISTs. CONCLUSIONS: The expressions of CD_ 117 and CD_ 34 play an important role in diagnosis and treatment of GISTs. Diameter, mitotic activity, recourrance/metastasis ratio and positive ratio of CD_ 117 are highly potential malignant parameters. More of mitotic activity and CD_ 117 positivity intimate higher malignant potential. Most of stromal tumors outside of gastrointestinal duct are high malignant potential.