摘要
目的 探讨直肠间质瘤的免疫组化特征和临床诊治经验。方法 对 2 0例直肠间叶组织肿瘤进行CD117等免疫组化染色 ,对其中 16例直肠间质瘤的免疫表型、临床资料及随访结果进行分析。结果 确诊直肠间质瘤 16例 ,直肠平滑肌肉瘤 3例 ,直肠神经鞘瘤 1例。间质瘤组中良性 2例、交界性 1例、恶性 13例 ,CD117和CD34的表达率分别为 10 0 % ( 16 /16 )和 88% ( 14 /16 ) ;直肠间质瘤患者 ,平均发病年龄为 6 0岁 ,首发症状主要为排尿排便困难 ( 38% )和腹痛 ( 31% ) ,14例 ( 88% )肛诊阳性 ;术后 1、3、5年生存率分别为 89%、6 4 %、4 8% ,术后平均生存时间为 4 7个月。结论 直肠间质瘤是最常见的直肠间叶源性肿瘤 ,生物学行为常表现为恶性 ,易局部浸润和术后复发 ,早期诊断。
Objective To investigate the clinical diagnosis,treatment and immunohistochemical characteristics of rectal stromal tumors. Methods 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. Results 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 maliganant.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. Conclusions 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.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2004年第15期897-900,共4页
Chinese Journal of Surgery
关键词
直肠间质瘤
病理
免疫组化
免疫表型
治疗
诊断
Rectal neoplasms
Pathology,clinical
Surgical procedures,operative
Recurrence
Stromal tumor
