妊娠滋养细胞疾病中各型滋养细胞增殖情况的研究

The Proliferation in Different Types of Trophocytes in Women with Gestational Trophoblastic Disease

目的:探讨正常绒毛与妊娠滋养细胞疾病(GTD)中各型滋养细胞的增殖能力与疾病恶性程度间的关系,以及双重免疫组化技术在妊娠滋养细胞疾病中的应用。方法:采用双重免疫组织化学的方法,用HCG、HPL和黑素瘤细胞粘附分子(Mel-CAM)标记出不同类型的滋养细胞,再用细胞增殖标记物Ki-67检测其增殖情况。结果:①3种滋养细胞的免疫组化表达特征各不相同。Mel-CAM表达仅限于中间型滋养细胞(IT);②正常绒毛和GTD组织标本中,滋养细胞的总Ki-67标记指数随疾病的恶性程度增高呈升高趋势,但各组间差异无统计学意义(P>0.05);③细胞滋养细胞(CT)的Ki-67标记指数随疾病的恶性程度增高而增高,二者呈正相关(r=0.731,P<0.05);IT的Ki-67标记指数显示出相同的特点(r=0.679,P<0.05)。结论:Mel-CAM结合Ki-67的双重免疫组化法是研究妊娠滋养细胞疾病的一个有用的辅助方法;CT和IT的Ki-67标记指数对于辅助预测GTD的发展转归、判断疾病预后等有帮助。

Objective： To explore the proliferation of all kinds of trophocytes in gestational trophoblastic disease （GTD）, and the relationship between proliferation of trophocytes and the malignancy of GTD. Methods： Double immunohistochemical staining technique was used to detect the expression of Ki-67 in HC, G, HPL and Mel-CAM defined trophocytes in GTD.Results. ①The immunohistochemical staining feature in the three types of trophocytes were difference. The expression of Mel-CAM was specifically found in intermediate trophoblast （IT） only;② In human normal villi and GT-D, the total Ki-67 index of trophocytes increased accompanied with the increment of the malignancies of disease. However, there was no statistical significance among each group（ P〉 0.05） ;③ Ki-67 index in CT increased with the increase of the malignant of disease, and there was a positive correlation（ r= 0.731, P〈 0.05）, So as in IT （ r = 0.679, P 〈 0.05）. Conclusions： Double immunohistochemical staining technique combined Mel-CAM and Ki-67 is a useful technique in study of GTD, which is useful in predicting the prognosis and development of disease.