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目的 研究胃肠道间质瘤(gastrointestinalstromaltumors,GISTs)病理诊断特征及临床治疗方法。方法 对北京大学第一医院1990年1月至2 0 0 1年8月收治的GISTs进行光镜和超微结构复检,用EnVision二部法免疫组织化学方法检测波形蛋白、CD117(c kit)、CD34等8种抗原标记物在肿瘤中的表达情况。并对其中临床资料完整的30例病人的病理特点、外科治疗及预后进行回顾性分析。结果 复检确诊GISTs 87例,占同期胃肠道肿瘤的2 % (87/30 16 ) ,30例病人中恶性2 1例,良性7例,交界性2例;恶性者10例复发,复发率为4 7% (10 /2 1) ,其中8例死亡,5年生存率为6 2 % (13/2 1)。结论 GISTs是消化道常见的原发性间叶性肿瘤,CD117、CD34等免疫标记物配合使用可确诊;恶性GISTs单纯外科手术复发率高,预后不良。
Objective To study the pathological features and clinical treatment of gastrointestinal stromal tumors (GISTs). Methods The GISTs of Peking University First Hospital from January 1990 to August 2001 were examined by light microscopy and ultrastructure. EnVision immunohistochemical method was used to detect the expression of vimentin, CD117 (c kit) , CD34 and other eight kinds of antigenic markers in tumor expression. The pathological features, surgical treatment and prognosis of 30 patients with complete clinical data were retrospectively analyzed. Results Retrospective examination of 87 cases of GISTs, accounting for 2% (87/30 16) of gastrointestinal tumors in the same period, 30 cases of malignant in 21 cases, benign in 7 cases, borderline in 2 cases; 10 cases of malignant recurrence and recurrence rate 4 7% (10/2), of which 8 died and the 5-year survival rate was 62% (13/2 1). Conclusions GISTs is a common primary mesenchymal tumor in the digestive tract. CD117, CD34 and other immune markers can be used in combination with the diagnosis. GISTs have a high recurrence rate and poor prognosis.