【摘要】 目的　观察胃肠间质瘤 (GISTs)的临床病理学特征并探讨其病理诊断标准。方法　 10 9例胃肠间质瘤常规病理检查 ,其中 6 1例运用免疫组化方法检测波形蛋白 (vimentin)、CD34 、结蛋白 (desmin)、SMA和S - 10 0的表达。结果　GISTs成人多见 ,≥ 5 0岁占 76 % (83/10 9)。男多于女。 77%的GISTs发生于胃和小肠。GISTs由梭形细胞和上皮样细胞构成 ,波形蛋白和CD34 有较高表达 ,分别为 90 .1%和 83.6 % ,少数病例结蛋白、SMA和 (或 )S - 10 0局灶性或少数个别细胞阳性表达。常规组织学与平滑肌 (肉 )瘤、神经鞘瘤有时易混淆 ,免疫组化染色有助于明确诊断。本组按Lewin并结合Hurliman和Goldbum提出的标准判断GISTs的良恶性 ,结果良性 46例 ,恶性 43例 ,潜在恶性 2 0例。结论　GISTs具有一定的临床病理特征及较特异性的免疫表型 (CD34 阳性 ) ;GISTs良恶性有时需综合分析、判断 ,实践表明Lewin等的标准就目前来说是较切实可行的更多还原

【Abstract】 Objective To investigate the clinicopathologic features of gastrointestinal stromal tumors (GISTs)and discuss their diagnostic criteria.?Method In addition to light microscopic observations , immunohistochemical assays of vimentin, CD 34 , desmin, SMA and S 100 were used.?Results Most of the patients with GISTs were adult, the patients ≥50 years old accounted for 76%(83/109), and the male outnumbered the female. 77% of the tumors originated in the stomach and small intestines. The GISTs showed two basic cell types spindle and epithelioid. Positive rates of vimentin and CD 34 in GISTs were 90.1% and 83.6% respectively. A few GISTs were desmin ,SMA and(or) S 100 positive, usually in focal areas or single cells. Some of them were difficult to differentiate from leiomyomas and schwannomas without immmunohistochemical aids. In this study, the Lewin’s criteria for diagnoses of benign and malignant GISTs, with some modifications, were applied. In the 109 cases, there were 46 cases benign,43 malignant and 20 potentially malignant.?Conclusion GISTs have some clinicopathologic features and quite peculiar immunophenotype (CD 34 positive ). The judgement of benign and malignant natures in some cases may depend on overall analyses. Experience proved,Lewin’s criteria are still the practicable at present.更多还原