胃肠道间质瘤临床病理特点分析.docVIP

胃肠道间质瘤临床病理特点分析 　【摘要】 　　目的：探讨胃肠道间质瘤（Gastric intestinal tumour,GIST）的生物学性质与临床病理特点的关系，为临床判断GIST的良、恶性提供参考。方法：回顾性分析本院2000年6月至2005年6月经手术和病理证实的38例GISTs病例的资料。结果：38例病人基本能完整切除肿瘤，26例良性，5例潜在恶性，7例恶性。光镜下细胞形态分类：梭形细胞为主型21例，上皮细胞为主型12例，混合细胞型5例。良性组肿瘤无明显出血、坏死，细胞无异型性，核分裂少见。恶性组肿瘤组可见出血坏死，细胞丰富，明显异型性，核分裂多见。免疫组化测定：CD117阳性32例, CD34阳性31例， Vimentin阳性28例，可溶S-100阳性15例, SMA）阳性10例。结论：GIST主要发生在胃和小肠，发病部位跟性别、年龄无关。CD117和CD34阳性标记是确诊GIST最有价值的免疫标记物。GIST的恶性程度与肿瘤是否出血坏死、大小、核分裂数密切相关，而与发生部位、性别、年龄、免疫表型无关，免疫表型与肿瘤部位也无关。 【关键词】 胃肠间质瘤 病理 免疫组化 　　Analyzing the Clinical Pathology Feature of Gastric Intestinal Tumour 　　　Abstract： Objective： To approach the relationship of gastrointestinal stromal tumor(GIST) between biology property and clinical pathology feature, and provide reference for the GIST clinical judgement. Method: Retrospectivly analysed 38 cases data in our hospital,which were proved by operation or pathology.Result:38 patients are under tumorectomy , 26 patients are innocuousness , 5 patients are potential malignancy and 7 patients are malignancy. The cytomorph classification of light microscope:21 cases are spindle cell , 12 cases are cellula epithelialis and 5 cases are mixed cellularity. Innocuousness tumor group have no manifest bleeding and necrosis. Cells have no heteromorphism and less caryocinesia. Malignancy tumor group are abundance of cellulars and haemorrhage 、necrosis 、heteromorphism、caryocinesia are manifest. Immunohistochemistry determination:32 cases are CD117(+),31 cases are CD34(+),28 cases Vimentin(+),15 cases S-100(+),and 10 cases SMA(+).Conclusion:GIST mainly occur in stomach and intestinal. onset location independence with gender and age. CD117 and CD34 active marker is the most valuable immunotumor marker to final dianosisi GIST. Malignancy degree of GIST are close correlate with tumor?s size、caryocinesia、bleeding and necrosis.But have no correlation with location、sex and immunophenotype. Immunophenotype has no relationship with location too. 　　Key words： Gastric intestinal tumour(G