葡萄胎受精类型与恶变的关系探讨

Relationship between malignant transformation and fertilization types of hydatidiform mole

目的探讨葡萄胎受精类型与恶变的关系。方法应用激光捕获显微切割技术(LCM)获取150例病理学诊断为葡萄胎的病理蜡块组织中的滋养细胞,提取DNA;用16个位点复合微卫星序列PCR方法对DNA进行分析,明确受精类型;通过追踪患者刮宫后血绒毛膜促性腺激素(HCG)变化判断葡萄胎是否恶变。对受精类型和恶变进行相关性分析。结果成功提取126例葡萄胎标本DNA液。其中86例DNA完全来自父方的遗传学完全性葡萄胎中恶变15例,DNA来自双亲的单倍体卵子双精子受精的遗传学部分性葡萄胎40例中恶变1例,二者恶变率相比P<0.05。遗传学完全性葡萄胎中空卵单精子受精的纯合性葡萄胎56例,恶变11例,空卵双精子受精的杂合性葡萄胎30例,恶变4例。纯合、杂合葡萄胎恶变率相比P>0.05。结论 DNA完全来自父方的遗传学完全性葡萄胎与DNA来自双亲的遗传学部分性葡萄胎相比易于恶变,前者恶变发生与其纯、杂合性无关。

Objective To investigate the relationship between malignant transformation and fertilization types of hydatidiform mole（HM）. Methods The pure trophoblastic ceils of 150 HM were obtained by Laser capture micro-dissection （LCM）. All the specimens were examined by multiplex STR-PCR, then to determine the fertilization types of HM. Whether malignant transformation or not of h,：3atidiform mole were determine through the tracking patients after uterine apoxesis blood human chorionic gonadotropin （HCG） . Results The numbers that we successfully extracted DNA from all the 150cases by LCM were 126 cases. Genetics complete hydatidiform moles, with DNA from only paternal origin, were observed in 86 case including 56 homozygote and 30 heterozygote case. In homozygote and heterozygote case, malignant transformation occurred in 1 lcase of the empty eggs fertilized by single sperms and 4 by double sperms respectively. In all the 126 HMs, 40 cases of DNA from parents were genetic partial hydatidiform moles, and 1 case malignant transformation occurred in each haploidy egg fertilized by double sperm. Conclusion Genetics complete hydatidiform moles show a higher malignant transformation risk than genetic partial hydatidiform moles. There is no significant difference in malignant trans- formation between homozygote and heterozygote of g-CHM.