Fas及FasL在妊娠滋养细胞疾病中的表达及意义

Expressions and significances of Fas and FasL in gestational trophoblastic diseases

目的探讨Fas及FasL在妊娠滋养细胞疾病中的表达及意义。方法应用免疫组化方法分别检测Fas及FasL蛋白在正常滋养细胞（40例）、完全性葡萄胎（36例）、侵蚀性葡萄胎（15例）、绒毛膜癌（11例）中的表达。结果Fas在正常滋养细胞组、完全性葡萄胎组、侵蚀性葡萄胎组和绒毛膜癌的阳性表达率分别为95．0％、88．9％、46．7％和36．4％。Fas随着妊娠滋养细胞疾病的进展阳性率逐渐降低。正常滋养细胞组分别与侵蚀性葡萄胎组及绒毛膜癌组比较有显著性差异（X2=14．036，P=0．000；，=16．575，P：0．000），完全性葡萄胎组与侵蚀性葡萄胎组和绒毛膜癌组比较有显著性差异（X2=8．275，P=0．004；X2=10．202，P=0．001），而正常滋养细胞组与完全性葡萄胎组、侵蚀性葡萄胎与绒毛膜癌组比较无显著性差异（X2=0．314，P=0．575；X2=0．015，P=0．902）。FasL在正常滋养细胞组、完全性葡萄胎组、侵蚀性葡萄胎组和绒毛膜癌组的阳性表达率分别为17．5％、44．4％、53．3％和81．8％。FasL随着妊娠滋养细胞疾病的进展阳性率逐渐增高。正常滋养细胞组分别与完全性葡萄胎组、侵蚀性葡萄胎组及绒毛膜癌组比较有显著性差异（X2=6．518，P=0．035;X2=5．371，P=0．005；X2=13．724，P=0．000），完全性葡萄胎组与绒毛膜癌组比较有显著性差异（，=4．727，P=0．030），完全性葡萄胎组与侵蚀性葡萄胎组、侵蚀性葡萄胎与绒毛膜癌组比较无显著性差异（X2=0．336，P=0．562；X2=1．191，P=0．275）。Fas与FasL表达在各组之间均呈负相关。结论Fas的低表达和FasL的高表达降低了妊娠滋养细胞凋亡，可能是妊娠滋养细胞疾病的发病机制之一。Fas和FasL的表达在各组之间均呈负相关提示二者在妊娠滋养细胞疾病进展中可能相互影响，共同作用。

Objective To investigate expressions of Fas and FasL in human gestational trophoblastic diseases （GTDs） and explore its role in pathogenesis GTDs. Methods Immunohistochemical method was used to detect expressions of Fas and FasL in normal villi of 40 women, complete hydatidiform mole of 36 women, invasive hydatidiform mole of 15 women and choriocarcinoma of 18 women. Results The positive expression rates of Fas in normal villi group, hydatidiform mole group, invasive hydatidiform mole group and choriocarcinoma group were 95.0%, 88. 9%, 46. 7% and 36. 4% respectively. From normal villi to hydatidiform mole, invasive hydatidiform mole and choriocarcinoma, the positive expression rate of Fas showed an descending tendency. The expression of Fas in normal villi group was higher than that in either invasive hydatidiform mole group or choriocarcinoma group and there was a significant difference between normal villi group and invasive hydatidiform mole group, choriocarcinoma group （X2 = 14. 036, P = 0. 000 ; X2 = 16. 575, P = 0.000）. Also, there was a significant difference between complete hydatidiform mole group and invasive hydatidiform mole group, choriocarcinoma group in expression of Fas （X2 = 8. 275 ,P =0.004;X2 = 10. 202 ,P = 0. 001 ）. While between normal villi group and complete hydatidiform mole group, and between invasive hydatidiform mole group and choriocarcinoma group, there was no significant difference in expression of Fas respectively （X2 = 0. 314,P = 0. 575;X2 = 0.015 ,P = 0. 902）. The positive expression rates of FasL in normal villi group, complete hydatidiform mole group, invasive hydatidiform mole group and choriocarcinoma group were 17.5%, 44.4%, 53.3% and 81.8% respectively. From normal villi to complete hydatidiform mole, invasive hydatidiform mole and choriocarcinoma, the expression of FasL showed an ascending tendency. There was a significant difference between normal villi group and complete hydatidiform mole group, invasive hydatidiform mole group and choriocarcinoma group respectively （X2 = 6. 518 ,P = 0. 035 ; X2 = 5. 371, P = 0. 005 ; X2 = 13. 724, P = 0. 000 ）. While between invasive hydatidiform mole group and choriocarcinoma group, there was no significant difference in expression of FasL （X2 = 1. 191, P = 0.275 ）. The expression of Fas was negatively correlated to expression of FasL in each group. Conclusion The decreased expression of Fas and increased expression of FasL might reduce apoptosis of gestational trophoblastic cells, which may be one of pathogeneses of GTD. Negative correlation between expression of Fas and expression of FasL in each group suggests that they may affect each other and play synergetic roles in development of GTD.