E-钙粘素在妊娠滋养细胞疾病的表达及其对葡萄胎恶变预测的价值

Expression of E-cadherin and its prognostic value in gestational trophoblastic diseases

目的探讨E-钙粘素在妊娠滋养细胞疾病的表达及其对葡萄胎恶变预测的价值。方法应用免疫组化SP法检测22例正常早孕绒毛和55例妊娠滋养细胞疾病石蜡包埋组织中E-钙粘素的表达情况,结合临床资料进行结果分析。结果E-钙粘素在正常早孕绒毛和非恶变葡萄胎的表达差异无显著性(P>0.05);恶变葡萄胎、侵蚀性葡萄胎和绒癌的表达量明显低于正常早孕绒毛和非恶变葡萄胎(P<0.05);侵蚀性葡萄胎和绒癌的表达量低于恶变葡萄胎(P<0.05)。葡萄胎恶变与E-钙粘素的表达呈负相关(P<0.05);与血β-HCG值、卵巢黄素化囊肿呈正相关(P<0.05)。结论E-钙粘素的表达下调可能是滋养细胞恶性转化的早期事件,在妊娠滋养细胞疾病的恶化进展中起重要作用;E-钙粘素可作为葡萄胎恶变预测的参考指标。

Objective To investigate the expression of E-cadherin and its prognostic value in gestational trophoblastic diseases. Methods The expression of E-cadherin in the paraffin-embedded tissues of 22 cases of normal chorionic villi of the first trimester,23 cases of non-malignant transformed hydatidiform mole,12 cases of malignant transformed hydatidiform mole,11 cases of invasive hydatidiform mole and 9 cases of choriocarcinoma was dectected by immunohistochemistry SP method. Results No significant difference of E-cadherin expression was found between the tissues of normal chorionic villi of the first trimester and that of non-malignant transformed hydatidiform mole（P〉0.05）. However,there was a significant reduction of E-cadherin expression in the tissues of malignant transformed hydatidiform mole and invasive hydatidiform mole as well as chorioncarcinoma compared with that of normal chorionic villi of the first trimester and non-transformed hydatidiform mole （P〈0.05）. The levels of the E-cadherin expression in the tissues of invasive hydatidiform mole and chorioncarcinoma were lower than that of malignant transformed hydatidiform mole（P〈0.05）. The expression of E-cadherin in the tissues of choriocinoma was apparently decreased compared with that of invasive hydatidiform mole,but the difference was not significant statistically（P〉0.05）.The malignant transformation of hydatidiform mole was inversely correlated to expression of E-cadherin （P〈0.05）,whereas it was directly correlated to blood HCG and overian corpus luteum cyst （P〈0.01,P〈0.05）. Conclusion Down-regulation of E-cadherin expression,regarded as an initial step in the malignant transformation of trophoblasts,played an important role in the malignant progression of gestational trophoblastic diseases. Therefore,the detection of the levels of E-cadherin expression might be valuable for the prediction of malignant transformation and the evaluation of prognosis in gestational trophoblastic diseases.