maspin和c-erbB-2在妊娠滋养细胞疾病中的表达及临床意义

The expression and clinical significance of maspin and c-erbB-2 in gestational trophoblastic disease

目的探讨maspin和c-erbB-2在妊娠滋养细胞疾病中的表达及临床意义。方法收集225例葡萄胎患者,随访3~27个月,27例发展为侵蚀性葡萄胎,12例发展为绒毛膜癌。采用免疫组化PV9000二步法检测24例正常早期妊娠（对照组）、49例葡萄胎（葡萄胎组）、39例妊娠滋养细胞肿瘤（侵葡＋绒癌组）maspin和c-erbB-2的表达。结果葡萄胎组maspin阳性表达率（65.3%,32/49）与对照组（91.7%,22/24）及侵葡＋绒癌组（35.9%,14/39）比较,差异有统计学意义（P〈0.05）。hCG〉105 U/L、子宫体积〉孕周及卵巢黄素囊肿直径〉6cm组maspin阳性率分别为34.6%（18/52）、37.0%（20/54）和36.6%（15/41）,均低于无上述高危因素组（P〈0.05）。葡萄胎组c-erbB-2阳性表达率（53.1%,26/49）与侵葡＋绒癌组（74.4%,29/39）比较,差异有统计学意义（P〈0.05）。子宫体积〉孕周组c-erbB-2阳性表达率（74.1%,40/54）与子宫体积≤孕周组（44.1%,15/34）比较,差异有统计学意义（P〈0.05）。葡萄胎组maspin与c-erbB-2的表达呈负相关（r=-0.270,P〈0.05）。侵葡＋绒癌组FIGO预后评分≥7分组maspin表达较〈7分组明显下降（P〈0.05）。结论maspin和c-erbB-2可作为预测葡萄胎恶变的参考指标,maspin的检测可能对妊娠滋养细胞疾病预后评估有一定的参考意义。

Objective To analyze the expression and correlation of maspin and c-erbB-2in gestational trophoblastic disease,and to investigate their role in the development of hydatidiform mole.Methods The expression of maspin and c-erbB-2was detected in 24 cases of normal early pregnancy（control group）,49 cases of hydatidiform moles without maliganant transformation（mole group）,39 cases progressed to gestational trophoblastic tumors（malignant group）with the method of imunohistochemistry（PV9000）.Results The expression of maspin in hydatidiform mole group（positive rate 65.3%）was of great difference compared with that in control group（positive rate 91.7%）and maliganant group（positive rate 35.9%）（χ^2=5.814、7.528,P〈0.05）.In hydatidiform moles with malignant high risk factors such as hCG10^5 U/L,uterus volume 〉gestation weeks,lutein cyst of ovary6cm（positive rate 34.6%,37.0%,36.6%）,maspin expression was lower than those without risk factors groups（positive rate 77.8%,76.4%,66.0%）（P〈0.05）.The expression of c-erbB-2in maliganant group（positive rate 53.1%）was of great difference compared with that in the mole group（positive rate 74.4%）（χ^2=4.203,P〈0.05）.The expression of c-erbB-2in hydatidiform mole with risk factors that uterus volume gestation weeks（positive rate 74.1%）was higher than in those without risk factors（positive rate 44.1%）（χ^2=7.988,P〈0.05）.Maspin espression was negatively correlated with c-erbB-2（P〈0.05）.In 39 cases of malignant moles maspin expression in FIGO prognostic score with high-risk group was lower than the low risk group（χ2=4.785,P〈0.05）.Conclusions Maspin and c-erbB-2may be used as a reference index of prediction of malignant transformation of hydatidiform mole.Detection of maspin may provide certain reference value in prognostic evaluation of gestational trophoblastic disease.