154例胃肠道间质瘤的临床病理和免疫组化特征.doc

154例胃肠道间质瘤的临床病理及免疫组化特征 来源：广东医学杂志?点击数： 699?更新时间：2007-4-25?文章录入：Admin ????154例胃肠道间质瘤的临床病理及免疫组化特征????罗容珍?梁小曼?何洁华?侯景辉?饶慧兰????中山大学肿瘤防治中心病理科（广州 510060）????【摘要】目的探讨胃肠道间质瘤（GIST）的临床病理、免疫组化特点及危险度参考指标。方法应用光镜观察154例GIST的形态特征，用免疫组化L-SAB法检测CD117，CD34，vimentin，HHF35，S100蛋白及bcl?2在GIST中的表达情况。结果154例GIST占同期消化系统间叶肿瘤的88，年龄20～92岁(平均55岁)，男女之比为 1。镜下梭形细胞为主型138例（89），上皮样细胞为主型7例（4），混合细胞型9例（5）。免疫组织化学显示CD117及CD34的阳性率分别为68和92，HHF35部分有灶性的表达，S100蛋白一般不表达，bcl?2阳性率较高(70。结论GIST是消化道最常见的间叶性肿瘤，CD117，CD34，vimentin,HHF35，S-100蛋白联合使用可协助鉴别诊断GIST。肿瘤直径大于 5 cm、核分裂数大于5/50HPF可作为高恶性潜能参考指标。????【关键词】胃肠道间质瘤病理形态免疫组化Gastrointestinal stromal tumors： a clinicopathologic and immunohistochemical study of 154 cases Luo Rongzhen, Liang Xiaoman, He Jiehua, et al. Department of Pathology, Cancer Center, Sun Yat-sen University, Guangzhou 510060????【Abstract】ObjectiveTo investigate the clinicopathologic and immunohistochemical features of gastrointestinal stromal tumors?(GIST) and? the reference parameters for malignancy.? MethodsThe clinicopathologic characteristics of GISTs were studied in 154 cases using light microscopy. The expression of CD117, CD34, vimentin, HHF35, S-100 and bcl 2 were detected in all cases with L-SAB staining. Results154 cases of GIST were equivalent to 88%?(154 to 175) of all? mesenchymal tumors of gastrointestinal tract in the same period. The age range was 20～92 years?(mean 55 years). Male to female was 157 to 1. Microscopically, 138 were of spindle cell type, 7 were of epitheloid cell type and 9 were of mixture type among 154 cases of GIST. Immunohistochemically, the positive rates of CD117 and CD34 were 688% and 929% respectively. HHF35 showed focal expression in some cases. S100 protein was generally not expressed and positive rate of bcl 2 was high?(701%). ConclusionGIST were the most frequent mesenchymal tumor of the gastrointestinal tract.? Application of immunohistochemical markers?(CD117,CD34,Vimentin,HHF35 and S-100) is? necessary for? differential diagnosis. Diameter greater than 5