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目的 :进一步探讨胃肠道间质瘤 (GISTs)的组织起源及病理诊断问题。方法 :18例手术切除标本常规石蜡切片、电镜制片及免疫组化EnVision法标记 ,光镜及电镜观察。结果 :本组 18例光镜下组织学形态均表现为梭形细胞。电镜观察 :无明显平滑肌及神经分化者 14例 ,伴有平滑肌分化的 3例 ,伴有神经分化的 1例。免疫组化染色 :18 18例CD117阳性和 15 18例CD34阳性 ,SMA同时阳性者 1例 ,S 10 0同时少量阳性者 2例 ,Desmin和NSE均为阴性。 18例GISTs被诊断为恶性 13例 ,良性 5例。结论 :GISTs是一类具有特征性的独立的肿瘤 ,CD117是GISTs较具特异性的标记物。目前GISTs的良恶性诊断仍需通过包括光镜、电镜观察在内的多种综合指数判断并结合临床随访
Objective: To further investigate the origin of tissue and pathological diagnosis of gastrointestinal stromal tumors (GISTs). Methods: Eighteen surgical specimens were removed from paraffin sections, electron microscopy, and immunohistochemical EnVision markers. Light microscopy and electron microscopy were performed. Results : The histological morphology of 18 cases of this group were spindle cells. Electron microscopy: There were 14 cases without obvious smooth muscle and nerve differentiation, 3 cases with smooth muscle differentiation, and 1 case with nerve differentiation. Immunohistochemical staining: 18 18 cases of CD117 positive and 158 cases of CD34 positive, 1 case of SMA positive simultaneously, and S 10 0 with a few positive cases in 2 cases. Both Desmin and NSE were negative. Eighteen cases of GISTs were diagnosed as having malignant in 13 cases and benign in 5 cases. Conclusion: GISTs are a class of independent tumors, and CD117 is a specific marker of GISTs. At present, the diagnosis of benign and malignant GISTs still needs to be judged by multiple indices including light and electron microscopy, combined with clinical follow-up.