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目的:探讨肝转移性胃肠道间质瘤(GISTs)的临床病理、免疫组化特点.方法:复习文献,分析15例肝转移性GISTs的临床表现、组织学及免疫组化特征.结果:本组15例肝转移性GISTs,原发灶分别位于小肠(6例)、胃(5例)及网膜(2例),余2例来源不明.发现肝转移灶与原发肿瘤手术相距时间为0 d-86 mo(平均25 mo±9 mo).肿瘤大小为1.5-30.0(平均7.1±1.2)cm.6例伴有出血、坏死或囊性变.组织学分型:梭形细胞型11例,上皮样细胞型2例,混合型2例.免疫组化结果:肿瘤细胞弥漫表达CD117(86.7%)、CD34(46.7%),灶性表达SMA(33.3%)、S-100(20%),Desmin均为阴性.结论:肝脏是GISTS最常见的转移部位,原发部位多为小肠和胃.其临床表现、组织形态及免疫组化表型与原发灶基本一致.预后较差.CD117和CD34联合应用有助于鉴别诊断.
Objective: To investigate the clinicopathological and immunohistochemical features of hepatic metastatic gastrointestinal stromal tumors (GISTs) .Methods: The clinical data, histology and immunohistochemical characteristics of 15 cases of hepatic metastatic GISTs were reviewed.Results: The group of 15 cases of liver metastatic GISTs, the primary tumor were located in the small intestine (6 cases), stomach (5 cases) and omentum (2 cases), the remaining two cases of unknown origin found liver metastases and primary tumor surgery time (Mean 25 ± 9 months) .Tumor size ranged from 1.5 to 30.0 (average 7.1 ± 1.2) cm.6 cases were associated with hemorrhage, necrosis or cystic degeneration.Histological typing: spindle cell type11 2 cases of epithelioid cell type and 2 cases of mixed type.Immunohistochemistry results showed that the expression of CD117 (86.7%), CD34 (46.7%), focal expression of SMA (33.3%) and S-100 ), Desmin were negative.Conclusion: The liver is the most common metastatic site of GISTS, the primary site is mostly the small intestine and stomach.The clinical manifestations, histomorphology and immunohistochemical phenotype are basically the same as the primary tumor, the prognosis is poor. The combined use of CD117 and CD34 contributes to the differential diagnosis.