154例胃肠道间质瘤的临床病理及免疫组化特征

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1、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

2、瘤的880%，年龄20～92岁(平均55岁)，男女之比为157∶1。镜下梭形细胞为主型138例（896%），上皮样细胞为主型7例（46%），混合细胞型9例（58%）。免疫组织化学显示CD117及CD34的阳性率分别为688%和929%，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1%)。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5cm、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

3、形态免疫组化Gastrointestinalstromaltumors：aclinicopathologicandimmunohistochemicalstudyof154casesLuoRongzhen,LiangXiaoman,HeJiehua,etal.DepartmentofPathology,CancerCenter,SunYat-senUniversity,Guangzhou510060    【Abstract】ObjectiveToinvestigatetheclinicopathologicandimmunohistochemicalfeaturesofga

4、strointestinalstromaltumors (GIST)and thereferenceparametersformalignancy. MethodsTheclinicopathologiccharacteristicsofGISTswerestudiedin154casesusinglightmicroscopy.TheexpressionofCD117,CD34,vimentin,HHF35,S-100andbcl2weredetectedinallcaseswithL-SABstaining.Results154casesofGISTwereequival

5、entto88% (154to175)ofall mesenchymaltumorsofgastrointestinaltractinthesameperiod.Theagerangewas20～92years (mean55years).Maletofemalewas157to1.Microscopically,138wereofspindlecelltype,7wereofepitheloidcelltypeand9wereofmixturetypeamong154casesofGIST.Immunohistochemically,thepositiveratesofC

6、D117andCD34were688%and929%respectively.HHF35showedfocalexpressioninsomecases.S100proteinwasgenerallynotexpressedandpositiverateofbcl2washigh (701%).ConclusionGISTwerethemostfrequentmesenchymaltumorofthegastrointestinaltract. Applicationofimmunohistochemicalmarkers (CD117,CD34,Vimentin,HH

7、F35andS-100)is necessaryfor differentialdiagnosis.Diametergreaterthan5cmandmitoticactivityover5/50HPF isahighly potentialmalignantparameters.    【Keywords】GastrointestinalstromaltumorClinicopathologicImmunohistochemical胃肠道间质瘤（gastrointestinalstromaltumor