hnRNP E1对妊娠滋养细胞疾病恶变的早期预测价值评估

The clinical value of hnRNP E1 in the early diagnosis and prediction of malignant transformation of hydatidiform mole

目的:通过分析hnRNP E1蛋白在良性及恶变转归葡萄胎中的表达,评估其在妊娠滋养细胞疾病恶变中的预测价值。方法:选取2007年至2008年因葡萄胎在南京市妇幼保健院清宫的40例患者,收集葡萄胎清宫标本。根据患者5年内的预后情况将早期清宫标本分为:良性转归组(29例)和恶性转归组(11例)。放射免疫法测定清宫前血清β-HCG水平,免疫组化法检测葡萄胎组织中hnRNP E1蛋白的表达及分布情况,RT-PCR检测葡萄胎组织中hnRNP E1 mRNA的表达,Western blot法检测葡萄胎组织中hnRNP E1蛋白的定量表达。结果:hnRNP E1蛋白在葡萄胎组织中主要表达于滋养细胞的细胞核及细胞质中。恶性转归组葡萄胎组织中的hnRNP E1 mRNA和蛋白相对表达水平分别为(0.49±0.18,0.89±0.24),均显著低于良性转归组(1.15±0.24,1.61±0.31)(P<0.05)。hnRNP E1表达与葡萄胎恶变及血清β-HCG水平呈负相关(P<0.05)。结论:hnRNP E1表达下调可能是滋养细胞疾病恶性转化的早期事件。hnRNP E1有望成为预测葡萄胎恶变的新靶标之一,为临床预防性化疗提供有力的理论依据。

Objective：To evaluate the clinical value of hnRNP E1 in the early diagno- sis and prediction of malignant transformation of hydatidiform mole（HM）. Methods：40 patients diagnosed with complete HM were selected as the subject. Their serum β-HCG were detected by Chemiluminescence before uterine evacuation and HM samples were collected immediately after uterine evacuation. These samples were divided into two groups：non-malignant hydatidiform mole group and malignant transformed hydatidiform mole group according to their prognosis re- sults 5 years later. Immunohistochemistry was used to detect hnRNP E1 expression. RT-PCR and Western Blot were used to detect hnRNP E1 mRNA and protein expression respectively be- tween two groups. Results：hnRNP E1 was detected in the nucleus and cytoplasm of tropho- cytes. The expression levels of hnRNP E1 mRNA and proteinin malignant transformed hydatidi- form mole （0.49±0.18,0.89±0.24） were significantly lower than those in non-malignant hy- datidiform mole（ 1.15±0.24,1.61 ±0.31 ） （P〈0.05）. There was a negative correlation be- tween hnRNP E1 expression and malignant transformation of hydatidiform mole, serum β-HCG level（P〈0.05）. Conclusions：The down-regulation of hnRNP E1 may be an early event in the malignant transformation of hydatidiform mole. hnRNP E1 may become a new index of predic- ting malignant transformation of hydatidiform mole, which provides a basis for preventive chemo- therapy.