摘要
目的探讨胃肠道间质瘤(GISTs)的临床特征和免疫组织化学分析。方法对外科手术切除的胃肠道肿瘤标本用光镜初步观察,拟诊为间叶性肿瘤者再进一步检查CD117、CD34、波型蛋白、结蛋白等抗原标记物在肿瘤中的表达情况。CD117阳性者,或CD117阴性而CD34阳性、结蛋白阴性者诊断为间质细胞瘤。结果42例GISTs患者中,胃28例,小肠11例,结肠、网膜及肠系膜各1例。临床主要表现为腹胀、腹痛(18/42)、消化道出血(17/42)和腹部肿块(10/42)。GISTs良性12例、潜在恶性10例和恶性20例。光镜下细胞主要呈梭型(60%)和上皮细胞型(13.3%),细胞排列呈栅栏状、旋涡状。CD117、CD34、波形蛋白在肿瘤细胞中的阳性表达率分别为100%、100%和97.6%,而S-100和平滑肌肌动蛋白的阳性表达率仅为14.3%和4.8%,结蛋白无表达。结论GISTs主要发生在胃和小肠。CD117、CD34可作为诊断胃肠道间质细胞瘤的免疫标记物。
Objective To investigate the clinical characteristic and immunohistochemistry of the gastrointestinal stromal tumors （GISTs）. Methods Clinicopathologic features of GISTs were evaluat- ed. Specimens obtained from patients who had undergone surgical resection for suspected GISTs of the gastrointestinal tract were first studied by light microscopy, than expression of CD117, CD34, viementin, desmen etc. were examined with SP method progressively. GISTs were defined as CD117- positive or CD34-positive, desmin-negative tumors. Results Forty two patients with GISTs were identified. The primary tumor locations were the stomach （ n = 28）, small bowel （ n = 12）, rectum, mesentery and omentum （ n = 1, respectively）. The main clinical manifestations included abdominal pain（18 cases）, gastrointestinal bleeding（17 cases）, abdominal mass（ 10 cases）. A total of 42 patients were 12 benign, 10 borderline, and 20 malignant cases. Histology revealed typical GIST features with spindle（60 % ）, epithelioidl（ 13.3 % ）, or mixed appearance（26.7 % ）. Expression of CDl17, CD34, vimentin was 100%, 100% and 97.6% while S-100 was 11.9%, smoothmuscle actins 4.8%, but negative for desmin. Conclusion GISTs are located in the stomach and small intestine predominantly. CD117, CD34 can be used to diagnose GISTs as an immunomarker.
出处
《苏州大学学报（医学版）》
CAS
北大核心
2005年第4期641-643,共3页
Suzhou University Journal of Medical Science
