妊娠滋养细胞疾病中EMT相关蛋白CK-18、波形蛋白的表达及意义

The Expression of EMT Associated Protein CK-18 and Vimentin in Gestational Trophoblastic Disease

目的检测上皮细胞间质细胞转化(EMT)相关蛋白——细胞角蛋白18(CK-18)和波形蛋白(vimentin)在正常早孕绒毛、葡萄胎及妊娠滋养细胞肿瘤中的表达及与临床病理特征的关系。方法采用免疫组化法(SP法)检测39例正常早孕绒毛组织、33例葡萄胎组织和32例妊娠滋养细胞肿瘤组织(侵袭性葡萄胎27例、绒毛膜癌5例)中CK-18、vimentin的定位及表达情况。结果 CK-18在各种类型滋养细胞中呈强阳性表达,正常绒毛组的CK-18表达水平高于葡萄胎组及妊娠滋养细胞肿瘤组,差异有统计学意义(P<0.01),葡萄胎组CK-18表达高于滋养细胞肿瘤组,差异有统计学意义(P<0.01);vimentin于各组滋养细胞中呈弱阳性表达,各组间的表达差异无统计学意义(P>0.05)。在葡萄胎滋养细胞轻度增生组,CK-18蛋白的相对表达量高于滋养细胞中或重度增生组(P<0.01)。在滋养细胞肿瘤解剖学Ⅰ期组CK-18蛋白的相对表达量高于解剖学Ⅱ期及以上组(P<0.001)。结论伴随着滋养细胞恶性度的升高CK-18的表达逐渐降低,提示EMT可能与滋养细胞的恶性转化有相关性。

Objective To analyze the expression and clinicopathologic features of epithelial to mesenchymal transition（EMT）associated protein of cytokeratin-18（CK-18）and vimentin in gestational trophoblastic disease（GTD）.Methods Immunohistochemistry was used to determine theexpression of CK-18 and vimentin in normal pregnancy villis（39cases）,hydatidiform mole（HM）（33cases）and gestational trophoblastic neoplasia（GTN）（invasive mole 27 cases and choriocarcinoma 5cases）.Results The GTN group had significantly lower levels of CK-18 compared with the normal pregnancy villis group and the HM group（P〈0.01）.Vimentin was weakly positive in all kinds of trophocyte.There was no significance among normal pregnancy villis,HM and GTN groups（P〉0.05）.In HM,expression level of CK18 was significantly lower with the increase of the pathological malignancy（P〈0.01）.And in GTN,the expression of CK-18 was significantly lower with the increase of the tumor anatomy stage（P〈0.001）.Conclusion The expression of CK-18 decreases with the increase of tropohblast malignancy,which indicates that CK-18 may be involved in malignant transformation of trophocytes and EMT may play an important role in the malignant transformation of GTN.