【摘要】 目的探讨胃肠道间质瘤 (GISTs)的诊断及免疫组织化学在诊断中的价值以及治疗原则。方法对 1990～ 2 0 0 1年经手术治疗的 35例GISTs的临床病理资料进行分析总结 ,对GISTs进行光镜观察 ,用S P免疫组织化学方法检测 6种抗原标记物在肿瘤中的表达情况。结果35例GISTs占同期消化系统间叶组织源性肿瘤的 74 .4 %(35 / 4 7) ;其中梭形细胞为主者占 2 7例 ,上皮样细胞为主者 4例 ,两种细胞混合者 4例。免疫组化学显示肿瘤组织中抗原标记物表达阳性率Vimentin为 10 0 %、CD117为 88.5 %、CD3 4 74 .1%。结论GISTs是消化道最常见的间叶组织源性肿瘤 ,形态学与平滑肌源性肿瘤和神经源性肿瘤难于区别。CD117和CD3 4 等免疫标记物的配合使用可做出正确判断 ;肿瘤大小、核分裂相、细胞异型性 ,是诊断良性、交界性和恶性GISTs的主要参考指标更多还原

【Abstract】 ObjectivesTo evaluate the diagnosis of gastrointestinal stromal tumors(GISTs) and explore the significance of immunohistochemical techniques in their diagnosis as well as the principle of treatment.MethodsForty seven patients with GISTs were treated by operation from 1990 to 2001.Their clinicopathological data were collected and analyzed retrospectively. The morphologic characteristics of GISTs were studied by using light microscopy. The expressions of 6 antigen markers-CD 117 , CD 34 , vimentin, S 100, MBP and HHF35 in GISTs were detected by S P immunohistochemical method.Results27 cases of GISTs were spindle cell type,4 were epithelioid cell type and 4 belonging to mixture type,equivalent to 74.4%(35 /47)of all mesenchymal tumors in gastrointestinal tract. The positive expression rates of antigen markers in 35 GISTs were: vimentin(35/35,100%),CD 117 (31/35,88.5%)and CD 34 (25/35,71.4%).ConclusionGISTs are the most frequent mesenchymal tumors seen in the gastrointestinal tract. Under light microscope, morphology of stromal tumors looks sometimes like a leiomyoma /Schwannoma. Correct judgment can be made if immunohistochemical markers(particularly CD 117 and CD 34 )are used to help the differential diagnosis. Tumor size, nuclear mitotic activity and atypia of cells can serve as the essential criteria in differentiation among benign, borderline and malignant GISTs.更多还原