Rb蛋白在滋养细胞疾病中的表达及其临床意义

The expression and clinical significance of Rb protein in gestational trophoblastic disease.

目的探讨Rb基因蛋白在妊娠滋养细胞疾病时的表达及其临床意义。方法采用免疫组化方法,检测石蜡包埋的161例妊娠滋养细胞疾病和20例正常早孕绒毛组织Rb蛋白表达水平。结果Rb在部分滋养细胞和合体滋养细胞中表达。正常早孕绒毛组的Rb表达与非恶变葡萄胎组差异无显著性(P>0·05),但显著弱于恶变葡萄胎组(P<0·01),非恶变葡萄胎组Rb表达显著弱于恶变葡萄胎组(P<0·05)。侵蚀性葡萄胎、绒癌Rb表达显著强于葡萄胎(P<0·01,P<0·01),但侵蚀性葡萄胎与绒癌的Rb表达差异无显著性(P>0·05)。滋养细胞重度增生者Rb表达显著强于滋养细胞轻度增生者(P<0·05)。葡萄胎恶变与子宫大小、卵巢黄素化囊肿密切相关。结论Rb表达增强是导致滋养细胞恶变因素之一,Rb表达增强在葡萄胎恶变过程中可能有重要的生物学意义。

Objective To study the expression and clinical significance of Rb protein in gestational trophoblastic disease（GTD）. Methods 161 cases of GTD and 20 cases of normal chorion villi tissue specimens were examined by immunohistochemical techniques using Rb monoclonal antibody. Results Rb was detected immunohistochemically in syncytiotrophoblasts and cytotrophoblasts. No significance difference was found between normal chorion villi and non - malignant transforming group（NMTG） （ P 〉 0.05）. Expression of Rb was significantly stronger in malignant transforming group（MTG） as compared to normal ehorion villi and NMTG respectively （ P 〈 0.01, P 〈 0.05）. Rb immunostain in invasive mole and choriearcinoma were significantly stronger as compared with hydatidiform mole （ P 〈 0.01 ）, but there was no significant difference of Rb expression between invasive mole and choriocarcinoma （P 〉 0.05）. Expression of Rb in highly trophoblastic proliferation was significantly stronger than in gently trophoblastic proliferation （P 〈 0.05）. Size of the uterus and presence of theca lutein cysts were closely related with hydatidiform mole malignant transformation. Conclusion The increased expression of Rb in trophoblast may result in malignant transformation and probably be associated with the modulate excessive trophoblastic proliferation.