印迹基因p57^kip2蛋白在水泡状胎块诊断和分型中作用

Expression of imprinted gene p57^(kip2) in hydatidiform moles

目的探讨p57kip2蛋白表达在水泡状胎块诊断和分型中的作用和意义。方法应用免疫组化SP法检测p57kip2蛋白30例在完全性水泡状胎块(complete hydatidiform moles,CHMs)、25例部分性水泡状胎块(partial hydatidiform mole,PHMs)和20例水泡状流产(hydropic abortions,HAs)三组病变中的表达情况,正常成熟胎盘(normal mature placentas,NMPs)为正常对照。结果p57kip2蛋白在10例NMPs、20例HAs组织中的细胞滋养层细胞、绒毛间质细胞和绒毛外滋养细胞团核表达阳性,合体滋养层细胞不表达;CHMs的绒毛间质细胞和细胞滋养层细胞p57kip2蛋白不表达,阳性表达仅见于绒毛外散在滋养细胞团中;25例CHMs的绒毛间质细胞和细胞滋养层细胞p57kip2均表达阳性。结论p57kip2蛋白在CHMs和PHMs的表达和分布有明显差异,可作为胎块分型诊断的客观辅助指标,值得在国内妇产科病理诊断常规工作中推广应用。

Purpose To study the expression of imprinted gene p57^kip2 in hydatidiform moles and its effect on differential diagnosis of complete hydatidiform moles （CHMs） from partial hydatidiform moles （PHMs） and hydropic abortions （HAs）. Methods In this study, 30 cases of CHMs, 25 PHMs and 20 HAs were evaluated by immunohistochemistry of formalin-fixed tissues using a monoclonal antibody against p57^kip2 protein, a putative paternally imprinted inhibitor gene, while 10 normal mature placentas （NMPs） were as the control. Results In all 25 cases of PHMs, 20 HAs and 10 NMPs, nuclear p57^kip2 was strongly expressed in cytotrophoblasts, intermediate trophoblasts, villous stromal cells, and decidual stromal cells but was absent in syncytiotrophoblast. In CHMs, p57^kip2 expression in eytotrophoblasts and villous stromal cells was either absent. Conclusion The immunohistochemical analysis for p57^kip2 expression is a useful tool for the differential diagnosis of CHMs from PHMs and HAs.