目的探讨消化系统梭形细胞肿瘤的临床病理特点及诊断。方法对72例消化系统梭形细胞肿瘤的临床及病理资料进行复习,应用免疫组化SP法染色。结果 72例消化道梭形细胞肿瘤中,51例为胃肠间质瘤(GIST),其中25例发生在胃,其次是直肠多发,小肠和结肠较少;13例为平滑肌瘤,其中9例发生在食管;4例为炎性肌纤维母细胞瘤(IMT),3例为钙化性纤维性肿瘤(CFT),1例神经鞘瘤。GIST中CD117阳性率为86.4%,CD34阳性率为88.9%,55.6%GIST伴有actin和desmin灶性(+)。10例平滑肌瘤中actin、desmin及caldesmon均(+),而CD117、CD34及S-100均(-)。4例IMT中vimentin均(+),3例actin(+),CD117、CD34、S-100和desmin均(-)。3例CFT中vimentin均(+),1例CD34(+)。神经鞘瘤S-100(+)。结论消化系统梭形细胞肿瘤以GIST最多见,发生在胃最多;其次是平滑肌瘤,发生在食管多见。GIST生物学行为分为4个级别:极低、低、中和高危险度。IMT生物学行为中间型。CD117、CD34、actin、desmin、Ki-67和S-100可作为消化系统梭形细胞肿瘤的常规标记物。 Objective To investigate the clinicopathological features and diagnosis of spindle cell tumor in digestive system. Methods The clinical and pathological data of 72 cases of spindle cell tumor of digestive system were reviewed and stained with SP immunohistochemistry. Results Of the 72 cases of gastrointestinal spindle cell tumors, 51 were gastrointestinal stromal tumors (GISTs), of which 25 occurred in the stomach, followed by multiple rectal and small intestine and colon; 13 were leiomyomas, of which 9 Cases occurred in the esophagus; 4 cases were inflammatory myofibroblastic tumors (IMT), 3 cases were calcified fibroids (CFT) and 1 case was schwannoma. The positive rate of CD117 in GIST was 86.4%, the positive rate of CD34 was 88.9%, and 55.6% GIST was associated with actin and desmin focal (+). Actin, desmin and caldesmon were all found in 10 leiomyomas (+), while CD117, CD34 and S-100 (-). The vimentin (+), 3 actin (+), CD117, CD34, S-100 and desmin were all found in 4 cases of IMT (-). Three cases of CFT vimentin (+), one case of CD34 (+). Schwannoma S-100 (+). Conclusions Spindle cell tumor of digestive system is the most common in GIST, occurring in the stomach most, followed by leiomyoma, occurring more frequently in the esophagus. GIST biological behavior is divided into four levels: very low, low, medium and high risk. IMT biological behavior intermediate. CD117, CD34, actin, desmin, Ki-67 and S-100 are routine markers of spindle cell tumors of the digestive system.