Zhang Xu, Rong Tie-Hua, Wu Qiu-Liang, Fu Jian-Hua, Long Hao, Zhang Lan-Jun, Ma Guo-Wei, Su Xiao-Dong, Li Xiao-Dong, Wang Dao-Feng, Hu Yi, Yang Hong
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.
Ai Zheng. 2006 Jul;25(7):901-5.
BACKGROUND & OBJECTIVE: Esophageal stromal tumors and smooth muscle tumors are not easy to be distinguished in clinic though they have different pathologic features. This study was to compare the clinicopathologic features of esophageal stromal tumors and smooth muscle tumors, and discuss their treatments.
The expression of CD117 and CD34 in 16 specimens of primarily diagnosed esophageal leiomyoma, 4 specimens of esophageal leiomyosarcoma, and 1 specimen of stromal tumor was detected by immunohistochemistry. The clinicopathologic features of the patients were analyzed, and the treatment principles and curative efficacies were summarized.
Of the 16 cases of primarily diagnosed esophageal leiomyoma, 5 were CD117(+) and finally diagnosed as non-high aggressive fatal stromal tumor according to the assessment criteria of stromal tumors; 11 were CD117(-). The stromal tumor was CD117(+) and CD34(+), and diagnosed as high aggressive fatal stromal tumor. The 4 cases of primarily diagnosed esophageal leiomyosarcoma were CD117(-) and CD34(-). There was no obvious difference in clinicopathologic manifestations, treatment and prognosis between esophageal non-high aggressive fatal stromal tumor and leiomyoma, and between esophageal high aggressive fatal stromal tumor and leiomyosarcoma.
Esophageal stromal tumors and smooth muscle tumors can not be distinguished with clinicopathologic exhibitions. The immunohistochemical examination of antibody CD117 is necessary for identifying them. Lumpectomy or esophageal partial resection is enough for esophageal non-high aggressive fatal stromal tumor and leiomyoma. Esophageal partial resection is necessary for esophageal high aggressive fatal stromal tumor and leiomyosarcoma.
食管间质瘤和平滑肌瘤在临床上虽病理特征不同，但不易区分。本研究旨在比较食管间质瘤和平滑肌瘤的临床病理特征，并探讨其治疗方法。
采用免疫组织化学法检测16例初诊食管平滑肌瘤、4例食管平滑肌肉瘤及1例间质瘤标本中CD117和CD34的表达。分析患者的临床病理特征，总结治疗原则及疗效。
16例初诊食管平滑肌瘤中，5例CD117(+)，根据间质瘤评估标准最终诊断为非高侵袭性恶性间质瘤；11例CD117(-)。间质瘤CD117(+)、CD34(+)，诊断为高侵袭性恶性间质瘤。4例初诊食管平滑肌肉瘤CD117(-)、CD34(-)。食管非高侵袭性恶性间质瘤与平滑肌瘤、食管高侵袭性恶性间质瘤与平滑肌肉瘤在临床病理表现、治疗及预后方面无明显差异。
食管间质瘤和平滑肌瘤无法通过临床病理表现进行区分，抗体CD117的免疫组化检查对鉴别二者很有必要。食管非高侵袭性恶性间质瘤和平滑肌瘤行肿块切除或食管部分切除术即可。食管高侵袭性恶性间质瘤和平滑肌肉瘤则需行食管部分切除术。
