胃gastrointestinal stromal tumorの検討

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  • A STUDY OF GASTROINTESTINAL STROMAL TUMOR

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Since the cellular origin of gastrointestinal mesenchymal tumors (GIMT) is uncertain, the definite classification of them has not been established as yet. Recently it has been increasingly clarified that most of GIMTs may be gastrointestinal stromal tumors (GIST) derived from intestinal cells of Cajal (ICC) which reveal immunoreactivities to CD34 and membrane-bound tyrosine kinase receptor, Kit (CD117).<br> In this study a total of six patients with GIMT of the stomach treated in the hospital from 1994 to 1998 were reexamined clinicopathologically and immunohistochemically. Before entering the study, two cases were diagnosed as leiomyoma, two cases as leiomyosarcoma, and two cases as gastrointestinal autonomic tumor. In this reexamination, tissues from the six GIMTs were immunostaind for CD34, Kit, desmine (Des), alpha-smooth muscle actin (α-SMA) and S-100 protein (S100).<br> All the six GIMTs exhibited CD34(+), Kit(+), Des(-), α-SMA(-), S100(-) immunophenotype. After reexamination, all six GIMTs were diagnosed as GIST originated from ICC. No pure myoid nor schwannian (or neural) differentiation was seen in this series.<br> All tumors including one with liver metastasis were resectable. All the patients is still alive.<br> We need further accumulation of clinical cases to know malignancy and prognosis for GIST.

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