消化道及腹腔软组织平滑肌肿瘤的临床病理和免疫组化特点.pdfVIP

贵州医药2008年2月第32卷第2期 ·109 · 消化道 腹腔软组织平滑肌肿瘤的临床病理 和免疫组化特点 贵阳市第一人民医院病理科(55o001)张著学 李志义 贵阳医学院(5500O4)龚 灵 张薇珊一 成元华一 摘 要 目的 探讨消化道和腹腔软组织平滑肌肿瘤临床病理和免疫组化特点。方法对17 例消化道及腹腔软组织平滑肌肿瘤进行临床病理、免疫组化观察，并对7例患者进行随访。结果 男 性7例，女性1O例；年龄23~63岁，平均49岁。肿瘤位于胃肠道8例(食道2例，胃1例，结肠4例， 直肠1例)，位于腹腔9例(肠系膜2例，网膜2例，腹膜后5例)。临床表现无特异性，光镜下具有一 定特征。随访7例，3例平滑肌瘤均显示预后良好，4例平滑肌肉瘤中3例复发，1例死亡。SMA阳 性率100 (17／17)，Desmin阳性率94 (16／17)，CDll7、CD34、S-100蛋白、PDGFRA及PKC theta 均为阴性表达。结论消化道及腹腔软组织平滑肌肿瘤少见，发生于消化道者多为良性，发生于腹腔 者多为恶性。该肿瘤强表达SMA及Desmin，PDGH 或PKC theta可作为与胃肠道间质瘤鉴另U诊 断的标记物。 关键词 平滑肌瘤 平滑肌肉瘤 临床病理 Clinicopathological and immunohistochemical research on smooth muscle tlmu~of alimentary tract and abdominal soft tissue Zhang Zhu．rue，Li Zhiy ，Gong Ling，et a1．Depa~ment of Pathology Guiyang municipal No．1 peoplgs hospital and Guiyang medical college，Guiyang 550001 Abstract Objective To investigate the c1iniopatho1ogica1 and immunohistochemical features of smooth muscle tumor in alimentary tract and abdomina1 cavity．Methods Seventeen cases of smooth muscle tumor from alimentary tract and aMominal cavity were studied by clinicopathological analysis and immunohistochemical staining，and 7 of them accepted follow-up investigation．Results Among 17 smooth muscle tumor cases，7 from men and 10 from women，aged from 23 tO 63 years old(49 on av- erage)．7 cases occurred in digest tract(2 from esophagus，1 from stomach，4 from colon，1 from rec— turn)。while 9 cases occurred in aMomina1 cavity(2 from mesentery，2 from omentum，5 from retro- peritoneum)．No special clinical symptoms were found in these tumors，while some histopatho1ogica1 features were detected．3 follow-up cases of leiomyomas showed good prognosis，while 4 follow-up leiomyosarcoma s cases showed 3 cases developed recurrence and 1 died．Immunohistochemically。the tumor showed positive for SMA(100 ，17／17)，Desmin(94 ，16／17)，while negative for CD117， CD34，S-100，PDGFRA and