66例胃肠道间质瘤的免疫表达及其临床病理分析

目的通过对66例胃肠道间质瘤（gastrointestinal stromal tumors,GIST）的免疫组织化学研究,分析实验参数及病人的临床资料,探讨胃肠道间质瘤（GIST）的临床病理特征,为病理诊断和临床治疗提供帮助,提高GIST的临床诊治水平。方法收集我院1993-2005年所有经病理诊断并有充分的临床资料的病例66例进行研究,对66例GIST患者的临床资料和病理资料进行回顾性分析,并用免疫组化方法对标本做CD117、CD34、S-100、Desmin免疫组化研究。结果 66例病例中男性37例,女性29例,均行手术切除。发生的部位胃占66.7%（44/66）,小肠占25.7%（17/66）,其他7.6%（5/66）。良性25例,潜在恶性8例,恶性33例。CD117阳性表达率98%（65/66）,CD34阳性率71%（47/66）,Desmin阳性率6%（4/66）,S-100阳性率35%（23/66）。结论 GIST好发于中老年人,肿瘤直径大于10cm、肿瘤有坏死等影响病人的生存,CD117标记阳性是确诊GIST最重要的诊断依据,手术切除是GIST的主要治疗方法。

Clinical and Pathological Analysis of Gastrointestinal stromal tumours(GISTs)

【Objective】 Predicting the clinical behaviour of gastrointestinal stromal tumour（GISTs） is difficult and criteria delineating benign from malignant cases are not firmLy established.The arms of this study were to define the clinicopathological of 66 GISTs,and to determine wheather any specific parameters were associated with patient outcome.【Methods】 Expression of CD117,CD34,S-100 protein,keratin,SMA was determined by immunohistochemistry.【Results】 66 patients were diagnosed as GISTs,including 37 males and 29 females.including 25 benigns and 33 malignant,and 8 patients is low-grade malignant tumors.All patient were took operation.The tumors were situated in stomach 44 cases;in small intestine 17 case;in others 5 case.The expression of CD117 was positive in 65 of 66 GISTs patients（98%）,and The expression of CD34 was positive in 47 of 66 GISTs patients（71%）,S-100 positive in 23 of 66 GISTs patients（35%）,Desmin positive in 4 of 66 GISTs patients（6%）.【Conclusion】 GISTs predaminantly occurred in middle age or old patients.in this study,size ≥10cm and necrosis correlated significantly with adverse survival.The tumours were composed of spindle cells and epithelioid cells.The important immunohistochemical characters were positive for CD117.Operation is the principal method to this tumours.