胎盘部位滋养细胞肿瘤细胞增殖力的研究

StudyonCelularProliferationActivityofPlacentalSiteTrophoblasticTumor

目的：研究胎盘部位滋养细胞肿瘤（ＰＳＴＴ）的细胞增殖力与其良性临床经过和病理特征之间的关系。方法：收集本院收治的１０例ＰＳＴＴ患者病变组织存档蜡块，重新切片行组织学诊断，在此基础上分别作核分裂计数、细胞核仁组成区嗜银蛋白（ＡｇＮＯＲ）染色及流式细胞计数ＤＮＡ分析。以同期收治的葡萄胎与绒癌各５例为对照组。结果：ＰＳＴＴ的核分裂数为每１０个高倍视野０～３（平均１．３）；而葡萄胎和绒癌分别为０～２（平均０．８）和１～４（平均２．２）。ＰＳＴＴ的ＡｇＮＯＲ颗粒数为每个细胞２．７０±０．５５，而葡萄胎和绒癌分别为１．９６±０．３８和４．５０±０．７３。ＰＳＴＴ的ＤＮＡ指数为１．１０，Ｓ期比例为１６．７％，增殖指数为２６．６％。１０例ＰＳＴＴ中，８例随访至今，７例存活，１例术后３年死于原发性肺癌。结论：ＰＳＴＴ有较低的细胞增殖力，其良性临床过程和非恶性病理特征可能与ＰＳＴＴ二倍体ＤＮＡ及低细胞增殖力有关。

Objective:Tostudytherelationshipamongthecelularproliferationactivity,benignclinicalprocessandpathologiccharacteristicsofplacentalsitetrophoblastictumor(PSTT).Methods:Parafin-embeddedblocksfromtenpatientswithPSTTwerereexaminedbymitoticcount,argyrophilicnucleolarorganizerregions(AgNOR)stainingandflowcytometricDNAanalysis.Fivecasesofhydati-diformmole(HM)and5choriocarcinoma(CC)werechosenascontrols.Results:MeanmitoticfiguresofPSTTwere1.3(0～3)per10highpowerfield,whilethoseofHMandCCwere0.8(0～2)and2.2(1～4)respectively.AgNORnumberofPSTTwas2.70±0.55percel,whilethoseofHMandCCwere1.96±0.38and4.50±0.73respectively.FlowcytometricDNAcontentrevealedthatPSTThadDNAindex(DI)of1.10,Sphaseof16.7%andproliferatingindex(PI)of26.6%.Eightof10Caseswerefolowedup,7arealiveand1diedofprimarylungcancer.Conclusion:PSTThasrelativelowcelularproliferationactivity.ThegoodclinicalprocedureandbenignpathologicalfeatureofPSTTmaybeassociatedwithitsdiploidyDNAandlowcelularproliferationactivity.