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胃肠道平滑肌肿瘤的病理改变与预后的关系及其组织起源探讨

Smooth Muscle Tumors of Gastrointestinal Tract: A Study on Correlation between Pathology and Prognosis and Histogenesis

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【作者】 李挺; 李蜀华; 刘开凤; 谭永淑;

【Author】 Li Ting;Li Shuhwa;Liu Kaifeng;Tan Yongshu Department of Pathology

【机构】 华西医大病理学教研室; 华西医大病理学教研室; 华西医大病理学教研室 北京中日友好医院 研究生;

【摘要】 对73例胃肠道平滑肌肿瘤的病理改变与预后的关系的研究结果表明:核分裂相数是估计该肿瘤良、恶性程度及预后的最好指标。0个/10HPF为良性,1~9个/10HPF为低度恶性,≥10个/10HPF为高度恶性;在易查见核分裂相的肿瘤中,直径>6cm者较<6cm者预后差。免疫组化染色,结蛋白阳性率为43.83%。电镜观察,5例中3例查见向平滑肌分化的证据。文内还对该肿瘤的组织起源进行了探讨。

【Abstract】 Seventy three cases of gastrointestin-al smooth muscle tumors (GISMT) werecollected and their correlation betweenpathology and prognosis and their histo-genesis was studied. microscopically, thefollowing parameters were evaluated:1.celluarity; 2. grade of differentiation; 3.nuclear pleomorphism; 4.mitotic rate/10HPF.All cases were followed up, but fromonly 47 information was elicited.To studythe histogenesis, the technique of immuno-histochemical staining to desmin, S--100protein was used in all the cases and fivewere examined by EM. The results showedthat the mitotic rate was the most im-portant and reliable pathological parameterused to differentiate between benign andmalignant tumors, and to evaluate theprognosis of a given tumor;in the caseswhich showed active mitosis. tumor sizewas important to evaluate the prognosis;the other histologic parameters or less.if any,significance in evaluation of prog-nosis.The authors supported the hypoth-esis that GISMT might mainly be derivedfrom primary mesenchymal cells potentiated with smooth muscle cells diff eren-tiation.The hypothesis that GISMT arederived from nerve tissue waits forfurther evidence.

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