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目的探讨胃肠道间质瘤(GIST)的病理组织形态学和免疫组织化学特点及良、恶性肿瘤参考指标。方法手术切除后,测量肿瘤直径,观察有无出血、坏死,取材,若有肿大淋巴结也取材检查。标本均经10%的中性福尔马林固定。常规脱水石蜡包埋4mm切片,HE染色,免疫组化S-P二步法染色,分别行CD117、CD34、DOGl、SMA、S-100、Vimentin、Desmin、CK(AE1/AE3)免疫标记。结果恶性27例,交界性15例,良性22例。CD117阳性56例,占87.5%;Vimentin阳性56例,占87.5%;CD34阳性49例,占76.6%;DOG1阳性52例,占81.3%;SMA阳性26例,占40.6%;Desmin阳性10例,占15.6%;S-100阳性3例,占4.7%;CK阳性0例。结论 GIST临床表现无特异性,CD117和DOG1联合可提高GIST的诊断率,良、恶性肿瘤诊断需综合考虑病理组织形态学和免疫组化结果。
Objective To investigate the histopathological and immunohistochemical features of gastrointestinal stromal tumors (GIST) and the reference indexes of benign and malignant tumors. Methods After surgical resection, the diameter of the tumor was measured to see if there was bleeding, necrosis, drawing, and swollen lymph nodes. Specimens were fixed by 10% neutral formalin. Paraffin-embedded 4 mm sections were stained with HE and stained with S-P by immunohistochemistry. Immunofluorescent staining of CD117, CD34, DOG1, SMA, S-100, Vimentin, Desmin and CK (AE1 / AE3) were performed respectively. The results of malignant 27 cases, 15 cases of borderline, benign in 22 cases. CD117 positive in 56 cases, accounting for 87.5%; Vimentin positive in 56 cases, accounting for 87.5%; CD34 positive in 49 cases, accounting for 76.6%; DOG1 positive in 52 cases, accounting for 81.3%; SMA positive in 26 cases, accounting for 40.6%; Desmin positive in 10 cases, Accounting for 15.6%; S-100 positive in 3 cases, accounting for 4.7%; CK positive in 0 cases. Conclusion The clinical manifestations of GIST are nonspecific. The combination of CD117 and DOG1 can improve the diagnosis rate of GIST. The diagnosis of benign and malignant tumors need to consider the histopathological and immunohistochemical results.