中国实用外科杂志

中国实用外科杂志 ›› 2005, Vol. 25 ›› Issue (09): 1-530.

• 论蓍 •    下一篇

胃肠道间质瘤的免疫组化分析及临床诊治

周雷 王正康 杜家文 宋新 王岩 黄林平 王文跃 潘瑞芹   

  1. 中日友好医院普外科(北京，100029)
  • 收稿日期:2005-05-16 修回日期:2005-06-14 出版日期:2005-09-20 发布日期:2005-09-20

  • Received:2005-05-16 Revised:2005-06-14 Online:2005-09-20 Published:2005-09-20

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摘要：

目的 探讨胃肠道间质瘤的诊治、临床病理学及免疫组化特征。方法 收集1998～2005年收治的41例胃肠道间质瘤的临床病理学资料，进行免疫组织化学染色，标记抗体为CD117、CD34、SMA和S100蛋白。结果 危险程度极低2例，低度危险8例，中度危险19例，高度危险12例。肿瘤是否浸润黏膜肌层或浆膜层与危险程度相关(χ2=485，P<005)。CD117、CD34、SMA和S100蛋白阳性表达分别为90%、 83%、37%和25%，其阳性表达率与肿瘤危险程度无关(χ2=034、004、001、002，P>005)。结论 Fletcher的危险程度分类符合临床治疗与预后的需要。肿瘤浸润黏膜肌层或浆膜层是危险性的重要指标，而免疫表型与危险程度无关。肿瘤完全切除联合使用伊马替尼是改善预后的关键。

Abstract:

The immunohistochemical study and clinical diagnosis and treatment of gastrointestinal stromal tumors. Zhou Lei,Wang Zhengkang,Du Jiawen,et al.Department of General Surgery,ChinaJapan Friendship Hospital,Beijing 100029,China Abstract Objective To investigate the clinicopathologic and immunohistochemical features of gastrointestinal stromal tumors (GISTs). Methods The diagnosis and treatment results of GISTs were studied,and clinicopathologic features and immunohistochemical expressions of CD117,CD34,smooth muscle actin (SMA) and S100 protein were detected in 41 cases of GISTs from 1998 to 2005. Results According to the Fletcher classification,2 cases were very low risk,8 cases were low risk,19 cases were intermediate risk and 12 cases were high risk.The infiltration to the muscular layer of mucosa or the serous layer was correlated with the risk of GISTs significantly (χ2=485，P<0.05).The percentage of positivity of CD117,CD34,SMA and S100 protein was 90%,83%,37% and 25%,respectively.There was no significant difference in the expression of CD117,CD34,SMA and S100 protein among all the different risk groups (χ2=034、004、001、002，P>005). Conclusion The different risk categories of Fletcher for GISTs are coincidence with the requirement of clinical treatment and prognosis.The infiltration to the muscular layer of mucosa or the serous layer is an important predictor of the risk of GISTs,and the immunophenotype is not a predictor.Total resection of tumor combined with imatinibmesylate is the key way to improve the prognosis.