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目的 探讨胃肠道间质瘤的临床病理、免疫组化和超微结构特点。方法 40例胃肠道间质瘤行常规检查及免疫组化染色 ,其中 4例新鲜标本同时进行电镜检查。结果 72 .5 %的胃肠道间质瘤发生在胃和小肠。肿瘤可分为四个亚型 :平滑肌细胞分化型 45 % ;神经源性分化型 12 .5 % ;平滑肌和神经双向分化型 17.5 % ;未分化型 2 5 %。肌肉共同蛋白HHF 35在 18例平滑肌细胞型肿瘤中 ,17例有不同程度的阳性反应 ,为平滑肌细胞分化最敏感的标记物。未分化型间质瘤的免疫表型为Vimentin和CD34阳性 (10 0 % )。电镜检查可见各型分化的特点。结论 尽管胃肠道间质瘤的光镜下形态相似 ,但其免疫表现型却呈异源性 ,需要做免疫组化及电镜观察以准确定性
Objective To investigate the clinicopathological, immunohistochemical and ultrastructural features of gastrointestinal stromal tumors. Methods Forty cases of gastrointestinal stromal tumors were examined by routine examination and immunohistochemistry. Four fresh specimens were examined by electron microscopy at the same time. Results 72.5% of gastrointestinal stromal tumors occurred in the stomach and small intestine. Tumors can be divided into four subtypes: smooth muscle cell differentiation 45%; neurogenic differentiation 12.5%; smooth muscle and neural bi-directional differentiation 17.5%; undifferentiated 25%. Muscle protein HHF 35 in 18 cases of smooth muscle cell tumor, 17 cases have different degrees of positive reactions, the most sensitive markers of smooth muscle cell differentiation. The immunophenotypes of undifferentiated stromal tumors were Vimentin and CD34 (10%). Electron microscopy shows the characteristics of various types of differentiation. Conclusions Although the morphology of gastrointestinal stromal tumors is similar under light microscopy, their immunophenotype is heterogeneous and requires immunohistochemistry and electron microscopy to accurately characterize