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目的探讨胃肠道间质瘤(GIST)临床病理、免疫组织化学特征及预后特点。方法对58例手术切除的胃肠道间质瘤复习其临床特点及病理形态,运用CD117、CD34、PDGFR-α等抗体进行免疫组织化学分析,并随访35例。结果GIST58例中,发生于胃部35例,小肠10例,结肠5例,肠系膜3例,网膜2例,食管2例,直肠1例。主要症状有腹胀、腹痛、腹部包块、便血。镜下观察:分梭形细胞型,上皮细胞型,混合细胞型。免疫组化:CD117标记91%(53/58)阳性,CD34标记68.9%(40/58)阳性,PDGFR-α60.3%(35/58)。随访35例,良性10例,1例复发;恶性潜能未定9例,2例复发;恶性16例,4例复发,4例死亡。结论胃肠道间质瘤好发于中老年人,组织形态多变,结构多样。CD117联合CD34、PDGFR-α等有诊断及鉴别诊断作用,预后与组织学分级有关。
Objective To investigate the clinicopathological, immunohistochemical and prognostic features of gastrointestinal stromal tumors (GIST). Methods Fifty-eight surgical specimens of gastrointestinal stromal tumors were retrospectively reviewed for clinical features and histopathology. Immunohistochemical analysis was performed on CD117, CD34 and PDGFR-α antibodies and 35 cases were followed up. Results In GIST58 cases, 35 cases occurred in the stomach, 10 cases of small intestine, 5 cases of colon, 3 cases of mesentery, 2 cases of omentum, 2 cases of esophagus and 1 case of rectum. The main symptoms are bloating, abdominal pain, abdominal mass, blood in the stool. Microscopic observation: sub-spindle cell type, epithelial cell type, mixed cell type. Immunohistochemistry showed that 91% (53/58) were positive for CD117, 68.9% (40/58) for CD34, and 60.3% (35/58) for PDGFR-α. Follow up of 35 cases, benign in 10 cases, 1 case of recurrence; 9 cases of undetermined malignant potential, 2 cases of recurrence; 16 cases of malignancy, 4 cases of recurrence, 4 cases of death. Conclusion Gastrointestinal stromal tumors occur mainly in the middle-aged and elderly people, with various morphological changes and diverse structures. CD117 combined with CD34, PDGFR-α and other diagnostic and differential diagnosis, prognosis and histological grade related.