40例胃肠道间质瘤临床病理分析

诊断病理学杂志 2000年第1期第7卷 论著

作者：廖晓耘　 虞有智　 谢大鹤　 回允中

单位：北京医科大学人民医院病理科 100044

关键词：胃肠道间质瘤；免疫组织化学；超微结构；胃肠道自主神经瘤CD34

　　摘　要：目的 探讨胃肠道间质瘤的临床病理、免疫组化和超微结构特点。方法 40例胃肠道间质瘤行常规检查及免疫组化染色，其中4例新鲜标本同时进行电镜检查。结果 72．5％的胃肠道间质瘤发生在胃和小肠。肿瘤可分为四个亚型：平滑肌细胞分化型45％；神经源性分化型12．5％；平滑肌和神经双向分化型17．5％；未分化型25％。肌肉共同蛋白HHF-35在18例平滑肌细胞型肿瘤中，17例有不同程度的阳性反应，为平滑肌细胞分化最敏感的标记物。未分化型间质瘤的免疫表型为Vimentin和CD34阳性(100％)。电镜检查可见各型分化的特点。结论 尽管胃肠道间质瘤的光镜下形态相似，但其免疫表现型却呈异源性，需要做免疫组化及电镜观察以准确定性。

　　分类号：R735．2　文献标识码：A

　　文章编号：1007-8096(2000)01-0012-03

A clinicopathologic study of 40 cases of gastrointestinal stromal tumors

liao Xiaoyun,Yu Youzhi,Xie Dahe(Department of Pathology,People's Hospital,Beijing Medical University,Beijing 100044)

　　Abstract：Objective To investigate the clinicopathologic,immunohistochemical and ultrastructural features of gastrointestinal stromal tumors(GISTs). Methods 40 cases of GISEs were studied by routine stain,immunohistochemistry and 4 of them also by electronmicroscopy. Results 72.5 % of the tumors originated in the stomach and small intestines.The neoplasms were clas-sifted as follows:45% smooth muscle tumors;12.5% neurogenic differentiated tumors;17.5% mixed smooth muscle cell and neu-rogenic differentiated tumors;25 % undifferentiated GISTs,not other specified.The muscle common actin HHF-35,variably reactive with tumor cells composing 17 of 18 smooth muscle tumors,was found to be the most sensitive marker of leiomyocytic differentia-tion.The immunophenotype of undifferentiated GISTs was vimentin and CD34(100%).The electron microscopy showed specific features for respective differentiations of gISTs. Conclusions Despite their similar light microscopic appearance,GISTs are im-munophenotypically heterogeneous,requiring immunohistochemical,even ultrastructural studies for accurate characterization.

　　Keywords：Gastrointestinal stromal tumors Immunohistochemistry Ultrastructural Gastrointestinal autonomic nerve tumors CD34参考文献：

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收稿日期：1999-01-18

修稿日期：1999-06-18