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目的 探讨胃肠道间质瘤的组织起源和神经分化特征。方法 应用电镜和免疫组织化学对 2 0例胃肠道间质瘤的超微结构和神经分化相关抗原表达进行研究。结果 2 0例胃肠道间质瘤c kit表达均阳性。其中 7例超微结构存在神经分化 ,12例未见神经或肌细胞分化 ,仅有 1例存在向平滑肌纤维分化。神经分化形态表现为瘤细胞胞质和胞质突起内可见散在或簇状分布的致密核心颗粒 ,并形成突触样结构。并可见神经元样突起、饮液空泡和团丝样纤维。神经分化伴有致密核心颗粒病例在良性、交界性和恶性组各有 1例、1例和 5例。神经分化组病例神经分化相关抗原神经元特异性烯醇化酶、CD99、S 10 0和CD5 6阳性表达分别有 7例、7例、5例和 4例 ,均高于未定分化组。结论 胃肠道间质瘤和所谓的胃肠道自主神经肿瘤在组织形态和免疫表型都存在相互重叠现象 ,神经分化超微结构观察和神经分化相关抗原分析有助于确定胃肠道间质瘤的神经分化改变以及潜在的生物学行为
Objective To investigate the histological origin and neural differentiation of gastrointestinal stromal tumors. Methods The ultrastructure and expression of neural differentiation-related antigen of 20 gastrointestinal stromal tumors were studied by electron microscopy and immunohistochemistry. Results 20 cases of gastrointestinal stromal tumors c kit expression were positive. Among them, there were 7 cases of neuronal differentiation in ultrastructure, 12 cases had no differentiation of nerve or muscle cells, and only 1 case had differentiation to smooth muscle fibers. Neuronal differentiation manifested as dense core particles scattered or clustered in cytoplasm and cytoplasm of tumor cells and formed synaptic-like structure. And visible neuron-like protuberances, liquid vacuoles and fiber-like fibers. Neuro-differentiation with dense core particles cases in benign, borderline and malignant group, 1 case, 1 case and 5 cases. Neuronal differentiation-related antigen neuron-specific enolase, CD99, S 10 0 and CD 56 expression were found in 7 cases, 7 cases, 5 cases and 4 cases respectively, which were higher than those in untreated group. Conclusion Gastrointestinal stromal tumors and so-called gastrointestinal autonomic nerve tumors overlap each other in morphology and immunophenotype. The observation of neural differentiation ultrastructure and analysis of neural differentiation-related antigens may help to determine the relationship between gastrointestinal stromal Neural differentiation of tumors and potential biological behavior