Wan Yuan-Lian, Tang Jian-Qiang, Liu Ping, Liu Yu-Cun, Wang Xin, Wu Tao, Pan Yi-Sheng, Huang Yan-Ting
Department of General Surgery, First Hospital, Peking University, Beijing 100034, China.
Zhonghua Wai Ke Za Zhi. 2004 Aug 7;42(15):897-900.
To investigate the clinical diagnosis, treatment and immunohistochemical characteristics of rectal stromal tumors.
Immunohistochemical expression of CD117 was retrieved in 20 cases of mesenchymal tumors of the rectum. And we analyzed the immunohistochemical characteristics, clinical data of rectal stromal tumors, and the results retrospectively.
Sixteen cases of rectal stromal tumors, 3 cases of leiomyosarcomas and 1 case of schwannoma were diagnosed. Histologically, 2 cases of GISTs were classified as benign, 1 as borderline and 13 as malignant. All of rectal stromal tumors (100%) were strongly positive for CD117, and 14 cases (88%) positive for CD34. The demographic profile of rectal stromal tumors showed a male predominance with average age of 60 years old. The main symptoms were urinary retention, constipation and abdominal pain. 14 cases were positive in digital rectal examination. The recurrence rate of local and radical resection in malignant stromal tumors was 4/4 and 3/6. 1, 3, 5-year survival rates were 89%, 64%, 48%, respectively. After operation mean survival time of was 47 months.
The specific GIST constituted the majority of mesenchymal tumors in rectum. It usually showed malignant biological behavior. Invasion and recurrence were common. Earlier diagnosis and radical resection had better prognosis. Periodically following up can help to detect the recurrence timely.
探讨直肠间质瘤的临床诊断、治疗及免疫组化特征。
回顾性分析20例直肠间叶组织肿瘤中CD117的免疫组化表达情况,分析直肠间质瘤的免疫组化特征、临床资料及结果。
诊断出16例直肠间质瘤、3例平滑肌肉瘤和1例神经鞘瘤。组织学上,2例胃肠道间质瘤(GISTs)为良性,1例为交界性,13例为恶性。所有直肠间质瘤(100%)CD117呈强阳性,14例(88%)CD34呈阳性。直肠间质瘤的人口统计学特征显示男性居多,平均年龄60岁。主要症状为尿潴留、便秘和腹痛。直肠指检14例阳性。恶性间质瘤局部切除和根治性切除的复发率分别为4/4和3/6。1、3、5年生存率分别为89%、64%、48%。术后平均生存时间为47个月。
特异性胃肠道间质瘤占直肠间叶组织肿瘤的大多数。其通常表现出恶性生物学行为。侵袭和复发常见。早期诊断和根治性切除预后较好。定期随访有助于及时发现复发。