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目的:探讨研究胃肠道间质瘤的临床病理及免疫病理。方法:对36例GIST患者标本的临床病理及免疫病理进行回顾性分析。结果:本组GIST首发症状多为腹部隐痛不适,一部分为上消化道出血,其中,小肠发病率最高,占47.2%(17/36),直肠占13.8%(5/36);胃占33.3%(12/18);结肠占5.5%(2/18)。最小肿瘤0.6cm×0.4cm×0.5cm,最大肿瘤24cm×12cm×14cm。27例以梭形细胞为主,7例以上皮样细胞为主,2例兼有上皮样细胞特征以及梭形特征的混合细胞。本组GIST的CD117阳性率91.6%(33/36);CD34阳性率86.1%(31/36);SMA灶阳性率19.4%(7/36);Desmin、S-100均阴性;GIST 36例患者中,8例恶性,18例交界性,10例良性。结论:GIST中老年发病率较高,早期诊断困难,临床表现不明显,免疫组化联合使用,CD117和CD34的阳性率是诊断GIST的重要依据,在GIST的良恶性问题上,还要综合考虑,根据肿瘤生物学行为、肿瘤的大小以及组织学形态等进行判定。
Objective: To investigate the clinicopathological and immunopathological features of gastrointestinal stromal tumors. Methods: The clinical pathology and immunopathology of 36 cases of GIST were retrospectively analyzed. Results: Most of the initial symptoms of GIST were abdominal pain and discomfort, and part of them were upper gastrointestinal bleeding. Among them, the incidence of small intestine was the highest, accounting for 47.2% (17/36), rectum accounting for 13.8% (5/36), stomach accounting for 33.3% (12/18); colon accounted for 5.5% (2/18). The smallest tumor 0.6cm × 0.4cm × 0.5cm, the largest tumor 24cm × 12cm × 14cm. 27 cases were mainly spindle cells, 7 cases were mainly epithelioid cells, and 2 were mixed cells with epithelial-like cell features and spindle-shaped features. The positive rate of CD117 in GIST was 91.6% (33/36), the positive rate of CD34 was 86.1% (31/36), the positive rate of SMA was 19.4% (7/36) Among them, 8 were malignant, 18 were borderline, and 10 were benign. Conclusion: There is a high incidence of middle-aged and elderly patients with GIST, early diagnosis is difficult and the clinical manifestations are not obvious. Combined immunohistochemistry, the positive rate of CD117 and CD34 is an important basis for the diagnosis of GIST. On the basis of benign and malignant GIST, , According to tumor biological behavior, tumor size and histological morphology and other decisions.