论文部分内容阅读
目的探讨胃肠道间质瘤(GISTs)的临床诊治方法及病理免疫组化特征。方法对我院2003年8月至2006年6月经手术及病理证实为GISTs的26例病例作回顾性分析。用免疫组化SP法检测CD117、CD34、Vimentin、desmin及S-100等5种抗体的表达情况。结果26例GISTs中,胃12例,占46.2%;小肠10例,占38.5%;食管1例,占3.8%;直肠2例,占7.7%;肠系膜1例,占3.8%。其中良性9例(9/26),低度恶性9例(9/26),恶性8例(8/26)。位于小肠者均为交界性及恶性,其恶性度与其它部位的肿瘤相比差异有显著性(P<0.05),良、恶性间质瘤的大小比较差异有显著性(P<0.05)。术前诊断GISTs仅3例,术前诊断率为11.5%,多误诊为胃癌、平滑肌瘤等。CD117、CD34、Vimentin、desmin及S-100阳性率分别为92%(24/26)、88%(23/26)、100%(26/26)、4%(1/26)、12%(3/26)。结论GISTs可发生于任何年龄,但多见于50岁以上的中老年人。GISTs可发生在从食管到直肠的消化道的任何部位,主要发生在胃和小肠,肿瘤发生部位和大小与肿瘤良恶性密切相关。GISTs术前诊断较困难,CD117和CD34在间质瘤的诊断中具有重要价值。
Objective To investigate the clinical diagnosis and treatment of gastrointestinal stromal tumors (GISTs) and their pathological features. Methods A retrospective analysis was performed on 26 cases of GISTs confirmed by surgery and pathology from August 2003 to June 2006 in our hospital. The expression of CD117, CD34, Vimentin, desmin and S-100 were detected by immunohistochemical SP method. Results Among 26 GISTs, 12 cases were gastric, accounting for 46.2%; 10 cases were small intestine, accounting for 38.5%; 1 case was esophageal, accounting for 3.8%; 2 cases were rectal, accounting for 7.7%; Among them, 9 were benign (9/26), 9 were low-grade (9/26) and 8 were malignant (8/26). The small intestine was borderline and malignant. The malignancy was significantly different from that of other sites (P <0.05). The size of benign and malignant stromal tumors was significantly different (P <0.05). Preoperative diagnosis of GISTs only 3 cases, preoperative diagnosis rate was 11.5%, more misdiagnosed as gastric cancer, leiomyoma and so on. The positive rates of CD117, CD34, Vimentin, desmin and S-100 were 92% (24/26), 88% (23/26), 100% (26/26), 4% 3/26). Conclusion GISTs can occur at any age, but more common in the elderly over the age of 50. GISTs can occur anywhere in the digestive tract from the esophagus to the rectum, mainly in the stomach and small intestine. The location and size of the tumor are closely related to the benign and malignant tumors. Preoperative diagnosis of GISTs more difficult, CD117 and CD34 in the diagnosis of stromal tumors of great value.