胃肠道恶性间质瘤的临床病理分析
邱培才 王少洪
【提 要】 目的 探讨胃肠道恶性间质瘤（gist）的临床病理特征. 方法 分析了6例gist的临床
及病理特征.结果 6例恶性gist均无消化道梗阻.临床表现无特异性，广泛分布于胃（60%）,
小肠（30%）和其它部位（10%），10%～30%gist是恶性的，表现为腹腔内的扩散或肝转移；
常规病理学检查，gist与平滑肌瘤/肉瘤等其它类型的梭形细胞肿瘤不易区别，确诊需要免 疫组化
或/和电镜检查；免疫组化cd34（+），vimenti（+），desmin（-），actin （-） ， s-100（-）
；恶性gist应行根治性手术，影响预后的因素较多.结 论 gist具有独特免疫组化表型，是有别于
平滑肌肿瘤的一类成分复杂的间叶性肿瘤.
【关键词】 胃肠道 间质瘤 恶性 病理 临床
［中图分类号］ r 735［文献标识码］ a［文章编号］ 1008-634x(2000)04-0267-02
a clinicopathological study of gastrointestinal maligiant stromal tumors
qiu pei-cai wang shao-hong
（department of general s urgery,shantou central hospital,shantou 515031 china）
【abstract】 objective to investigate the clinical pathologica charact eristics of gimst
.meth ods six cases with gastrointestinal maligiant stromal tumor and correla tive literature
were retrospected and studied,we summarized the clinical patholo gical characteristics of the deseases.results there were 6 cases with abdominal pain,4 cases with abdominal mass,
3 cases with marasmus a nd weight loss,3 cases with degestive tract bleeding and anemia,
and no degestive tract obstruction in this 6 cases gimst.there was not specificity in c linical situation.it distributed widely in the stomach(60%),small intes tinal(30%) and other position(10%).10%～30%of the gist were maligiant (gimst),its evidence was intraabdominal
diffusion and hepati c metastasis.it was not easy to distinguish fusiform tumor cells be
tween gist and leiomyoma/leiomyosarcoma in routine pathologic examination. the final
diagnosis of gimst demanded to proceed immunohistchemistry and/or electron microscope.
it showed cd 34(+),vimenti(+),desmin(-),actin(-),s-100(-)in immunohistochemistry.gim st needed to make a radical operation.many factors affected prognosis.conclusions
gist/gimst posses unique phenotyp in immu nohistochemistry,it is a kinds of tumor of mesenchymal tissue with mixed compone nt distinguishing leiomyomal/leiomyosarcoma.
it needs to be studied furt her steps in therapeutic measures and prognostic agent.
【key words】 gastrointestinal tract； stromal tumor； maligiant； pathology； clinic
胃肠道间质瘤/恶性间质瘤（gastrointestinal /malignancy stromal tumor，gist） 是一类成
分复杂的间叶性肿瘤，具有独特免疫组化表型,由原始的、相对未分化的间质细胞 增生而形成的肿瘤.
现将近期确诊的6例恶性gist分析其临床病理特征.
1 临床资料
本组6例，男女各3例，年龄27～83岁，其中胃恶性间质瘤4例、空肠恶性间质瘤2例. 主要表现：
6例均有上腹疼痛/隐痛不适、4例上腹部肿块，3例消化道出血 （呕血/黑便）并贫血，3例术前有明
显的消瘦，均无消化道梗阻征.术前3例 胃镜2例未见异常、1例发现胃底肿块表面溃疡，粘膜充血水
肿；4例行胃肠钡餐2例无异 常、2例有胃/肠壁僵硬、钡剂漏出胃/肠腔外形成瘘道；5例b超、ct或
mri影像均显示腹 腔内实质性肿块，增强扫描见不均<作者: 汪涛同志 时间: 2007-7-27 14:25
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