LMP2和PPM1A在妊娠滋养细胞疾病组织中的表达及其意义

Expression and significance of LMP2 and PPMIA in gestationai trophoblastic disease

目的检测低分子质量多肽2（LMP2）和蛋白磷酸酶1A（PPM1A）在妊娠滋养细胞疾病组织中的表达，并探讨两者在预测葡萄胎恶变中的价值。方法采用免疫组化EnVision二步法检测196例完全性葡萄胎（其中28例恶变）组织中LMP2和PPM1A蛋白的表达，选择妊娠滋养细胞肿瘤12例（侵蚀性葡萄胎7例、绒毛膜癌5例）和正常妊娠绒毛20例作为对照，回顾性分析其临床病理资料。结果LMP2和PPM1A在细胞滋养细胞、合体滋养细胞和绒毛外滋养细胞中均有表达。LMP2在葡萄胎恶变者中的表达水平明显高于正常绒毛和葡萄胎良性转归者，分别为（6．79±2．38）、（3．10±1．65）、（5．26±2．63）分，分别比较，差异均有统计学意义（P均〈0．01）；而与妊娠滋养细胞肿瘤者[（6．42±2．68）分]比较，差异无统计学意义（P=0．113）。PPM1A在正常绒毛、葡萄胎（良性转归、恶变）和妊娠滋养细胞肿瘤组织中的表达水平依次下调，分别为（6．30±2．98）、（4．93±2．50）、（4．43±2．04）、（3．33±2．06）分，分别比较，差异均有统计学意义（P〈0．01），且葡萄胎恶变者的表达低于良性转归者（P=0．001）。LMP2表达与卵巢黄素化囊肿大小有关，PPM1A表达与子宫大小有关（P〈0．05）。LMP2与PPM1A的表达水平之间不存在相关性（P〉0．05）。结论LMP2高表达和PPM1A低表达可能在滋养细胞的运动、侵袭及葡萄胎的恶性转化中发挥着重要作用。通过检测葡萄胎首次清宫术组织中LMP2和PPM1A的表达，对判断葡萄胎的预后有一定的参考意义。

Objective To investigate the expression of low molecular mass polypeptide-2 （LMP2） and protein phosphatase 1A （PPMlA） in gestational trophoblastic disease and elucidate their predictive value in malignant transformation of hydatidiform mole. Methods The expressions of LMP2 and PPM1A protein in 196 complete hydatidiform moles （in which 28 cases with malignant transformation） , 7 invasive moles, 5 choriocarcinomas and 20 normal ehorionic villus were detected with the method of EnVision immunohistochemistry. Their clinicopathologic data were retrospectively analyzed. Results LMP2 and PPM1A protein expressed in cytotrophocytes, syncytiotrophoblast and extravillous trophoblast. The level of LMP2 expression in deteriorative hydatidiform mole was significantly higher than that in non-deteriorative hydatidiform mole or normal ehorionic villus （6.79 ±2. 38, 5.26 ±2. 63 and 3. 10 ± 1.65, all P 〈0. 01 ）, while there were no difference compared with gestational trophoblastic neoplasms （6. 42 ± 2. 68, P = 0. 113 ）. The level of PPM1A expression was highest in normal chorionic villus, and decreased gradually in hydatidiform mole （ non-deteriorative and deteriorative ） and gestational trophoblastic neoplasms （ 6. 30 ± 2.98, 4. 93 ±2.50, 4.43 ±2.04 and 3.33 ±2.06, all P〈0.01）; the level of PPM1A expression in deteriorative hydatidiform mole was significantly lower than that in non-deteriorative hydatidiform mole （ P = 0. 00l ）. The expression of LMP2 protein was correlated to theea Jutein ovarian cyst, the expression of PPMIA protein was related with uterine size （ P 〈 0. 05 ） . While, there was no correlation between theexpressions of the two proteins （ P 〉 0. 05 ）. Conclusions High expression of LMP2 and low expression of PPM1A might play an important role in the motility and invasiveness of trophoblast cells and malignant transformation of hydatidiform mole. Testing the expression of LMP2 and PPM1A in hydatidiform mole tissues of initial uterine evacuation might be have some reference significance in judging outcomes of hydatidiform mole.