p16及p15基因预测葡萄胎恶变的价值

THE VALUE OF p16 AND p15 GENES IN PREDICTING CANCERATION OF HYDATIDIFORM MOLE

①目的 探讨p16、p15基因及蛋白缺失与葡萄胎恶变的关系。②方法 应用PCR和免疫组化技术检测40 例葡萄胎和25 例早孕正常绒毛中p16、p15 基因的纯合性缺失及蛋白表达情况。③结果 早孕绒毛中p16、p15基因、蛋白表达均为阳性。葡萄胎中p16、p15基因及蛋白表达缺失率均高于早孕绒毛组织,差异有显著性(χ2=11.152、14.388,P<0.05)。葡萄胎恶变组P16、P15 蛋白表达联合阴性率高于无恶变组(χ2 = 4.675, P<0.05);葡萄胎恶变组中,伴随清宫前子宫大于妊娠月份、同时发生黄素囊肿且大于6 cm、清宫后HCG持续2 个月才消退者,其P16、P15 蛋白表达联合阴性率均高于非恶变组,差异有显著性(χ2 = 4.412, P< 0.05; P= 0. 014、0.038)。④结论 葡萄胎的发生、发展与p16、p15基因、蛋白表达缺失有关。葡萄胎中P16、P15 蛋白表达缺失可望成为预测葡萄胎恶变倾向的指标。

Objective To study the relationship between the homozygous deletion and protein expression of p16 and p15 and the carcinomatous change of hydatidiform mole. Methods Polymerase chain reaction（PCR） based analysis and immunohistochemical method were performed to search for homozygous deletion and protein expression of the two genes in the tissues of 40 cases of hydatidiform mole and 25 cases of normal chorion of early gestation. Results No deletion was detected and the expression of p16 and p15 were both positive in the chorion of early gestation. The homozygous deletion and protein expression of p16 and p15 genes in hydatidiform mole were significantly higher than that in the chorion of early gestation（χ^2=11. 152,14. 388,P〈0.05）. Conegative expressions of p16 and p15 genes and protein in hydatidiform mole which had become invasive or choriocarcinoma were higher than in other cases（χ^2=4. 675,P〈0.05）. A significant difference existed with enlarged uterus, theca lutein cysts more than 6 cm, and abnormal HCG values for more than 2 months after suction curettage（χ^2=4. 412,P〈0. 05,P=0. 014,0. 038）. Conclusion The homozygous deletion and expression loss of p16 and p15 are related with the generation and development of hydatidiform mole. p16 and p15 may be useful predictive indicators for carcinomatous change of hydatidiform mole.