Ionescu Sever, Barbu Emil, Ionescu Călin, Costache Adrian, Bălăşoiu Maria
Department of Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy; Surgery Clinic I, County Hospital, Cluj-Napoca, Romania;
Rom J Morphol Embryol. 2015;56(1):239-45.
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal malignancies of the digestive tract. Gastric localization is the most frequent. The aim of this study is to evaluate the importance of immunohistochemical factors (CD117, CD34, α-SMA, vimentin, p53, Ki67) in diagnostic and size tumor and mitotic activity as prognostic factors for these tumors. We present the case of a 66-year-old male patient with a giant gastric GIST. Like in the vast majority, the symptomatology in this patient has long been faint, despite the large tumor size, and when it became manifest, it was nonspecific. Imagery wise, the computer tomography (CT) scan was the most efficient, showing the origin of the tumor from the greater curvature of the stomach, its dimensions, as well as the relations with the other abdominal viscera. Surgery in this patient was en-bloc, according to the principles of GIST. The histological aspect is characterized by a proliferation of spindle cells positive for CD117 and CD34. Despite complete microscopic resection, the size of the tumor (25×20×27 cm) and the mitotic activity (21÷5 mm2) remains important relapse factor.
胃肠道间质瘤（GISTs）是消化道最常见的间叶性恶性肿瘤。胃是最常见的发病部位。本研究的目的是评估免疫组化因子（CD117、CD34、α -平滑肌肌动蛋白、波形蛋白、p53、Ki67）在诊断、肿瘤大小及有丝分裂活性方面作为这些肿瘤预后因素的重要性。我们报告一例66岁男性巨大胃GIST病例。与绝大多数病例一样，尽管肿瘤体积巨大，但该患者的症状长期不明显，症状出现时也不具有特异性。影像学方面，计算机断层扫描（CT）最为有效，显示肿瘤起源于胃大弯，其大小以及与其他腹部脏器的关系。根据GIST的治疗原则，该患者接受了整块切除手术。组织学表现为CD117和CD34阳性的梭形细胞增殖。尽管进行了显微镜下的完整切除，但肿瘤大小（25×20×27 cm）和有丝分裂活性（21÷5 mm²）仍是重要的复发因素。
