应用扫描电镜技术预测良性与侵蚀性葡萄胎(英文)

Prediction of benign and invasive hydatidiform moles by scanning electron microscopical technique

目的 探讨扫描电镜技术预测良性与侵蚀性葡萄胎的应用价值 .方法 运用扫描电镜技术观察葡萄胎 90例 (良性 6 0例 ,侵蚀性 30例 ) ,以 10例正常早期胎盘绒毛作对照 .在研究方法上 ,我们把患者血、尿 HCG(绒毛膜促性腺激素 )测定作为本研究的监测指标 ,当葡萄胎后 12 wk血、尿 HCG不下降至正常时视为恶性 .结果 16 0例良性葡萄胎的血、尿 HCG于葡萄胎后 12 wk内降至正常 ;30例侵蚀性葡萄胎中 ,2 9例 HCG于葡萄胎后 12 wk内超过正常 ,另有 1例于2 0 + 4wk超过正常 . 2良性与侵蚀性葡萄胎的扫描电镜图像有显著差别 :良性葡萄胎绒毛表面的微绒毛丰富 ,分布均匀 .侵蚀性葡萄胎绒毛表面的微绒毛相互融合 ,形成不规则斑块 .

AIM To investigate the practical value of scanning electron microscopical technique (SEMT) in the early diagnosis of benign and invasive hydatidiform moles. METHODS SEMT was performed to observe 90 cases with hydatidiform moles (60 cases with benign and 30 cases with invasive hydatidiform moles) and 10 cases with normal placental villis as the control. Set as the differential criterion for our study was the assay HCG (human chorionic gonadotropin) of both the blood and the urine of the patients. Those whose HCG of both the blood and the urine after hydatidiform moles did not drop to the normal level in 12 weeks were regarded as with the malignant moles. RESULTS ① HCG of both the blood and the urine of 60 benign hydatidiform moles decreased to the normal level (<3.1 IU·L -1 ) in 12 weeks after hydatidiform moles; HCG of 29 invasive hydatidiform moles was higher than the normal level (>3.1 IU·L -1 ) in 12 weeks and that of 1 hydatidiform mole increased after 144 days (>3.1 IU·L -1 ). ② There was a significant difference in image between the benign and the invasive hydatidiform moles. On the surface of the benign hydatidiform moles, there were rich and evenly distributed microvilli, but on the surface of the invasive hydatidiform moles, the microvilli were mixed into irregular spots. CONCLUSION The above results indicate that SEMT can be used to predict the benign and invasive hydatidiform moles.