Department of General Surgery, Tenth People's Hospital of Shanghai, Tongji University, School of Medicine, Shanghai 200072, China.
Department of Surgery, Beijing Cancer Hospital, Peking University School of Oncology, Beijing 100036, China.
Gastroenterol Res Pract. 2014;2014:202960. doi: 10.1155/2014/202960. Epub 2014 Feb 11.
Schwannomas are tumors arising from the nervous system that also occur infrequently in the gastrointestinal tract, most commonly in the stomach. This report characterizes 29 patients with benign or malignant gastric schwannomas. Surgical data and clinical follow-up information were available for 28 cases with a median postoperative duration of 57 months. Clinicopathological and immunohistochemical characteristics of benign and malignant schwannomas were analysed. Four cases (13.7%) were histologically diagnosed with malignant schwannoma. All tumors were positive for S-100 and CD56 proteins, displaying a diffuse staining pattern. Vimentin was expressed in 100% cases and all schwannomas were negative for smooth muscle actin, c-kit, and HMB-45. A significant difference was observed between the group of benign and malignant schwannomas as regards recurrences and metastasis after complete resection (P = 0.015). The survival time of patients with benign schwannomas was longer than the malignant group (P = 0.013), so gastric malignant schwannomas have a potential for recurrence and metastasis, with subsequently short survival. Complete resection with an attempt to remove all tumor tissue with negative margins is of paramount importance in the management of gastric schwannomas, particularly when they turn out to be malignant.
神经鞘瘤是起源于神经系统的肿瘤，也很少发生在胃肠道，最常见于胃。本报告描述了 29 例良性或恶性胃神经鞘瘤患者。28 例患者的手术数据和临床随访信息可用，术后中位时间为 57 个月。分析了良性和恶性神经鞘瘤的临床病理和免疫组织化学特征。有 4 例（13.7%）组织学诊断为恶性神经鞘瘤。所有肿瘤均对 S-100 和 CD56 蛋白呈阳性，呈弥漫性染色模式。波形蛋白在 100%的病例中表达，所有神经鞘瘤均对平滑肌肌动蛋白、c-kit 和 HMB-45 呈阴性。在完全切除后复发和转移方面，良性和恶性神经鞘瘤组之间存在显著差异（P=0.015）。良性神经鞘瘤患者的生存时间长于恶性组（P=0.013），因此胃恶性神经鞘瘤有复发和转移的可能性，随后生存时间较短。完全切除并尝试切除所有肿瘤组织，切缘阴性，对于胃神经鞘瘤的治疗至关重要，特别是当肿瘤为恶性时。
