妊娠滋养细胞疾病患者病变组织中CD146的表达及意义

Expression and significance of CD146 in gestational trophoblastic disease

目的探讨妊娠滋养细胞疾病(包括完全性葡萄胎、侵蚀性葡萄胎及绒毛膜癌)病变组织中细胞黏附分子CD146的表达变化及意义。方法采用免疫组化二步法检测80例完全性葡萄胎、37例侵蚀性葡萄胎、39例绒毛膜癌患者病变组织中CD146的表达,与30例正常胎盘绒毛中CD146的表达作比较。结果完全性葡萄胎恶变者CD146的表达较正常胎盘绒毛和完全性葡萄胎未恶变者显著增强(P均<0.01);CD146预测完全性葡萄胎恶变的敏感度和特异性分别为71.05%和78.57%。侵蚀性葡萄胎和绒毛膜癌组织中CD146的表达较完全性葡萄胎显著增强(P均<0.01)。CD146在滋养细胞肿瘤(包括侵蚀性葡萄胎及绒毛膜癌)晚期的表达显著强于早期(P<0.01),且预后高危者CD146表达显著强于低危者(P<0.01)。结论CD146对完全性葡萄胎恶变有一定的预测价值,其表达与滋养细胞肿瘤的临床分期及预后有关。

Objective To investigate the expression of cell adhesion molecule CD146 in gestational trophoblastic disease （including complete and invasive hydatidiform mole, choroicarcinoma）. Methods The expression of CD146 was detected by immunohistochemistry in 80 cases of complete hydatidiform mole, 37 cases of invasive hydatidiform mole, 39 cases of choriocarcinomas and 30 cases of normal villi. Results The expression of CD146 was remarkably elevated in malignantly transformed mole than that in normal villi and non- malignant transforming mole （P〈0.01 respectively）,the sensitivity and specificity of CD146 in predicting malignant transformation of complete hydatidiform mole was 71.05% and 78.57% respectively. CD146 expression in gestational trophoblastic tumor （GTT,including invasive hydatidiform mole and choroicarcinoma） was significantly higher than that in complete hydatidiform mole （ P 〈 0.01 respectively）. CD146 expression in late stage GTT was significantly higher than that in the early stage GTT（ P 〈 0.01）,and it was higher in high risk GTT than that in low risk GTT（P〈0.01）. Conclusions CD146 could predict the malignant transformation of complete hydatidiform mole. CD146 expression in GTT is correlated with clinical stage and prognosis.