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目的 从胃肠道间质瘤的免疫表型探讨其起源及分类。方法 采用微波修复抗原及免疫组织化学S -P法检测34例胃肠道间质瘤患者CD117、CD34、Vimentin、Desmin、SMA、MSA、S -100、NSE和NF的表达。 结果 病理学诊断良性11例、恶性11例、交界瘤12例 ,平均直径7.9cm ,平均核分裂数6个/10HPF ,并随I、II、III分级增高而增多。免疫组化染色证实 :CD117阳性34例(100%)、CD34阳性28例(82.4 %) ,Vimentin阳性18例(52.9 %) ,Desmin阳性9例(26.5 %) ,SMA阳性10例(29.4 %) ,MSA阳性7例(20.6 %) ,S100阳性11例(32.4 %) ,NSE阳性7例(20.6 %)及NF阳性13例(38.2%)。根据其免疫表型 ,34例GIST存在4种类型 :狭义GIST3例(1例恶性、2例良性)、biphasictype6例、neurogenictype13例及myogenictype12例。随访11例恶性肿瘤中有3例复发 ,5例死亡 ,均为II、III级 ,其平均核分裂数13个/10HPF。 结论 肿瘤大小、核分裂数为GIST良恶性诊断的重要指标 ,免疫组化染色有助于探寻肿瘤细胞起源及分类
Objective To investigate the origin and classification of gastrointestinal stromal tumor immunophenotype. Methods The expression of CD117, CD34, Vimentin, Desmin, SMA, MSA, S -100, NSE and NF in 34 cases of gastrointestinal stromal tumors were detected by microwave repair antigen and immunohistochemical S-P method. Results Pathological diagnosis of benign in 11 cases, 11 cases of malignant, 12 cases of borderline tumors, the average diameter of 7.9cm, the average mitotic count of 6 / 10HPF, and with I, II, III increased grade increased. Immunohistochemical staining showed that CD117 positive in 34 cases (100%), CD34 positive in 28 cases (82.4%), Vimentin positive in 18 cases (52.9%), Desmin positive in 9 cases (26.5%), SMA positive in 10 cases (29.4% , MSA positive in 7 cases (20.6%), S100 positive in 11 cases (32.4%), NSE positive in 7 cases (20.6%) and NF positive in 13 cases (38.2%). According to its immunophenotype, there are 4 types of 34 GISTs: 3 in narrow GIST (1 in malignant and 2 in benign), 6 in biphasic type, 13 in neurogenictype and 12 in myogenic type. Three cases of 11 malignant tumors were followed up and 5 died. All were grade II and III with an average of 13 mitochondria per 10 HPF. Conclusions Tumor size and mitotic number are important indexes for the diagnosis of benign and malignant GIST. Immunohistochemical staining is helpful to explore the origin and classification of tumor cells