E-钙粘素在妊娠滋养细胞肿瘤中的表达及意义

Expression of E-cadherin and its prognostic valuein gestational trophoblastic diseases

目的探讨E-钙粘素在正常早孕绒毛组织、葡萄胎组织、侵蚀性葡萄胎组织及绒毛膜癌组织中表达;及其对葡萄胎恶性转化过程中的预测价值。方法选择自2008年3月至2013年3月在新疆医科大学第一附属医院妇科住院的妊娠滋养细胞肿瘤患者108例,应用免疫组化SP法检测65例葡萄胎,36例侵蚀性葡萄胎,7例绒癌及30例(孕周小于12周)正常绒毛中E-钙粘素表达强度,结合临床资料进行结果分析。结果 E-钙粘素在正常早孕绒毛、葡萄胎、侵蚀性葡萄胎以及绒癌组织中均有表达,且表达强度呈递减趋势,经两两比较正常早孕绒毛和葡萄胎中表达强度差异有统计学意义(P<0.05);侵蚀性葡萄胎及绒癌表达强度差异无统计学意义(P>0.05)。葡萄胎恶变与年龄大于35岁,孕周大于12周,β-HCG>8周降至正常者呈正相关(P<0.05)。结论 E-钙粘素表达强弱与滋养细胞恶性程度呈负相关,是葡萄胎恶变的前提,可作为葡萄胎恶变预测的参考指标。

Objectlve To investigate the expression of E-cadherin and its prognostic value in gestational trophoblastie diseases. Methods A total of 108 patients hospitalized at department of gynecological at the first affiliated hospital of Xinjiang Medical University and treated as gestational trophoblastie cell disease from March 2008 to March 2013 were ehosen; The expression of E-eadhefin were detected by immunohistoehemistry SP method in 65 cases of hydatidiform mole, 36 eases of invasive mole, 7 cases of choriocareinoma and 30 eases of normal villi in less than 12 gestational weeks. Results E-cadherin were expressed in normal pregnancy villus, hydatidiform mole, invasive mole and ehorionie carcinoma tissues, and the value declined. Significant difference of E-eadherin expression was found between the tissues of normal ehorionic villi and that of hydatidiform mole （P 〈0.05）. However, there was no significant reduction of E-eadherin expression in the tissues of invasive mole and ehoriocarcinoma （P〈0.05）. The malignant transformation of hydatidfform mole was directly correlated co ages, gestational ages more than 12 weeks, beta HCG being normal 8 weeks later （P 〈0.05）. Conclusion E-cadherin is associated with the malignant potential of sertoh cell; E-eadherin expression was negatively correlated with malignant degree of sertoli cell. Therefore, detection of levels of E-cadherin expression, might be valuable for prediction of malignant transformation and evaluation of prognosis in gestational trophoblastic diseases.