Lou Yue-liang, Chen Hua, Zhang Xie-liang, Zhan Zhong-li
Pelvis Oncology Department, Tianjin Medical University Cancer Hospital, Tianjin 300060, China.
Zhonghua Zhong Liu Za Zhi. 2004 Jul;26(7):437-9.
To investigate the pathological diagnosis, surgical treatment and prognostic factors of gastrointestinal stromal tumors (GISTs).
The clinicopathological data of operated 96 patients with GISTs were analyzed retrospectively. Expression of CD117, CD34, SMA and S-100 was determined by immunohistochemical methods.
Expression of CD117, CD34, SMA and S-100 was 79.2% (76/96), 58.3% (56/96), 35.4% (34/96) and 9.4% (9/96). Benign tumor 23 and malignant 73. Of the malignant, the omentum was resected in 39 and the rest remained, of which the recurrent and metastatic rates were 5.1% and 26.5% (P < 0.05). The safety margin between the normal intestine and tumor was > 5 cm in 46 patients; while in the other 27 patients, it was < 5 cm. The recurrent and metastatic rates were 6.5% and 29.6% (P < 0.05), respectively. The 5-year survival rates of benign and malignant GISTs were 91.5% and 57.3% (P < 0.05).
The application of immunohistochemical markers CD117 and CD34 are supplementary to pathological diagnosis. The adapting of rational primary treatment, including complete tumor resection and prophylactic omentectomy, is able to reduce the recurrence of GISTs.
探讨胃肠道间质瘤（GISTs）的病理诊断、外科治疗及预后因素。
回顾性分析96例接受手术治疗的GISTs患者的临床病理资料。采用免疫组化方法检测CD117、CD34、平滑肌肌动蛋白（SMA）和S-100的表达。
CD117、CD34、SMA和S-100的表达率分别为79.2%（76/96）、58.3%（56/96）、35.4%（34/96）和9.4%（9/96）。良性肿瘤23例，恶性肿瘤73例。恶性肿瘤中，39例行大网膜切除术，其余未行，其复发率和转移率分别为5.1%和26.5%（P<0.05）。46例患者正常肠管与肿瘤之间的安全切缘>5 cm；另外27例患者安全切缘<5 cm。其复发率和转移率分别为6.5%和29.6%（P<0.05）。良性和恶性GISTs的5年生存率分别为91.5%和57.3%（P<0.05）。
免疫组化标志物CD117和CD34的应用有助于病理诊断。合理的初次治疗，包括完整切除肿瘤和预防性大网膜切除术，能够降低GISTs的复发率。
