65例胃肠道间质瘤的临床病理和免疫组化分析

目的:探讨胃肠道间质瘤的临床病理特征和免疫组化特征。方法:对GIST患者进行临床病理及免疫组织化学观察。结果:本组GIST最常发生于小肠占55.4%(36/65),其次为胃占27.7%(18/65),直肠占10.8%(7/65),结肠占6.2%(4/65)。肿瘤体积大小不一,最大者24.0 cm×15.0 cm×20.0 cm,最小者0.6 cm×0.7 cm×0.4 cm。梭形细胞51例,上皮样细胞11例,混合细胞(兼有梭形和上皮样细胞特征)3例。CD117阳性64例,CD34阳性57例,Vimetin阳性12例,SMA小灶阳性11例,Desmin和S-100均阴性。良性18例,交界性31例,恶性16例。结论:GIST发生部位多,形态学复杂,免疫组化联合检测有助于诊断和鉴别诊断,特别是CD117和CD34。但在GIST良、恶性诊断上仍需结合肿瘤的大体、组织学形态及生物学行为等综合考虑。

65 cases of gastrointestinal stromal tumor clinicopathologic and immunohistochemical analysis

Objective Discuss gastrointestinal stromal tumor the features of clinical clinicopathologic and immunohistochemical.Methods Observe 65 cases of GIST patients clinical pathological and immunohistochemical in our hospital.Results This occurs most often in the small intestine GIST group was 55.4%(36/65),followed by the stomach accounted was 27.7%(18/65),rectum accounted was 10.8%(7/65),colon was 6.2%(4/65).Tumor volume sizes,the largest 24.0 cm×15.0 cm×20.0 cm,smallest 0.6 cm×0.7 cm× 0.4 cm.Spindle cell were 51 cases,epitheliallike cells were 11 cases,mixed cell(spindle and epithelioid cells in both features) were 3 cases.CD117-positive were 64 cases,CD34-positive were 57 cases,Vimetin positive were 12 cases,SMA-positive were 11 cases of special treatment,Desmin and S-100 were negative.Benign in 18 cases,borderline in 31 cases,malignant in 16 cases.Conclusion GIST occurrence site and more complex morphology,immunohistochemistry combined detection of the diagnosis and differential diagnosis,special CD 117 and CD 34.However,in GIST benign and malignant diagnosis with cancer still gross,histological and biological behavior into account.