【摘要】 目的探讨胃壁钙化性纤维性肿瘤(calcifying fibrous tumor,CFT)临床病理特征及可能的发病原因。方法回顾性分析2012-04-18-2014-04-04新疆医科大学第一附属医院4例CFT患者的临床资料及组织形态学特征,应用免疫组化方法检测免疫表型,原位杂交检测EBER及HPV16/18,FISH技术及RT-PCR检测间变性淋巴瘤激酶(anaplasticlymphoma kinase,ALK),并复习相关文献。结果 4例患者中,男1例,女3例,年龄37~74岁,平均57.3岁。病变均发生于胃体,以黏膜下肿块表现,单发,最大径0.5~3.0cm。形态学与其他部位的钙化性纤维性肿瘤相似。免疫组织化学梭形纤维母细胞VIM阳性,CD117、Dog1、ALK1、F8a、HHV8、ER、SMA、DES、S100及AE1/AE3均阴性。浸润的淋巴细胞为多克隆性,以T细胞为主,且以CD8表达占优,浆细胞:IgG+,IgG4+。原位杂交EBER及HPV16/18检测阴性,FISH技术检测ALK基因无融合,RT-PCR结果显示ALK无突变。结论胃CFT以单发表现,中老年常见,多位于胃体,瘤体较小,临床呈良性。病原学EB、HIV及HPV检测阴性,与炎性肌纤维母细胞瘤无明确直接联系,疾病发生发展中以细胞免疫应答占优。更多还原

【Abstract】 OBJECTIVE To study the clinicopathology and pathologenesis of gastric calcifying fibrous tumor(CFT).METHODS Four cases of gastric CFT from First Affiliated Hospital,Xinjiang Medical University between April18 th,2012and April 4th,2014 were analyzed and related literatures were studied.RESULTS There were 1male and 3females,with age ranged from 37 to 74years(mean 57.3years).All tumors were located in body and revealed a polypoid submucosal mass,and the size ranged from 0.5to 3cm.Histologically,tumors showed hypocellular sclerosis with coarse collagen and scattered or patchy mononuclear inflammatory infiltrates composed plasma cells and lymphocytes.Psammomatous and dystrophic calcifications were found.Immunohistochemically,all tumors were positive for VIM,and negative for CD117,Dog1,ALK1,F8 a,HHV8,ER,SMA,DES,S100 and AE1/AE3.Plasma cells were positive for IgG and IgG4.In situ hybridization EBER and HPV16/18 tests were negative.ALK gene fusion and mutation were not detected.CONCLUSIONS Gastric CFT has a predilection for the stomach body,and smaller tumor size,older age at presentation,and uniformly benign course without recurrence.There is no histogenetic relationship between CFT and inflammatory myofibroblastic tumor.This disease develops dominantly in cell-mediated immune response.更多还原