胃间质瘤的内镜、临床病理及免疫组织化学特征

背景与目的:胃间质瘤作为一组独立的疾病,在消化道间叶性肿瘤中占有一定的比例,其组织起源仍不是十分清楚.本研究通过探讨胃间质瘤的内镜、临床病理及免疫组织化学特征,进一步加深对胃间质瘤的认识.方法:回顾性分析42例胃间质瘤患者的临床资料及内镜特点,并用免疫组化SP法观察42例胃问质瘤的CD117、CD34、平滑肌肌动蛋白(SMA)、Desmin和S-100蛋白表达并分析其与临床病理的关系.结果:42例胃间质瘤发生于胃底21例,胃体14例,胃窦7例;良性17例,交界性14例,恶性11例;胃镜表现为粘膜下半球型隆起或息肉状隆起.与周围分界清楚,表面可有糜烂或溃疡,胃镜下组织活检阳性率较低.42例胃间质瘤中梭形细胞型29例,上皮样细胞型5例,混合型8例;CD117、CD34免疫组化阳性率分别为92.86%及78.57%.结论:胃间质瘤有独特的形态特征,CD117和CD34同时检测有助于胃间质瘤的诊断.

Endoscopic, clinicopathologic and immunohistochemical features of gastric stromal tumor

BACKGROUND & OBJECTIVE: For gastric stromal tumor (GST), the low incidence and high diversity in endoscopic and pathologic manifestations lead to misdiagnosis. This study was to explore the features of GST in endoscopy and clinicopathology. METHODS: Clinical data of 42 GST patients, treated at the Second Affiliated Hospital of Sun Yat-sen University from Jan. 1996 to Jan. 2006, were analyzed for their clinicopathologic and endoscopic features. The expression of CD117, CD34, smooth muscle actin (SMA), Desmin and S-100 were detected by immunohistochemistry. Their correlations to clinicopathologic features of GST were analyzed. RESULTS: Of the 42 cases of GST, 21 (50.0%) were at the fundus, 14 (33.3%) at the body, and 7 (16.7%) at the antrum; 17 (40.5%) were benign, 14 (33.3%) borderline, 11 (26.2%) malignant. Endoscopically, GST presented submucosal hemispheroid or polypoid protuberant lesions with clear border. While the positive rate of gastroendoscopic biopsy was low. Of the 42 cases, 29 were spindle cell type, 5 were epithelial cell type, and 8 were mixed type. The positive rates of CD34 and CD117 were 92.86% and 78.57%. CONCLUSIONS: GST has unique morphologic features. Combined detection of CD117 and CD34 benefits the diagnosis of GST.