转化生长因子-β1与胎盘生长因子在葡萄胎预后中的意义

The prognostic role of TGF-β1 and PLGF in hydatidiform mole

目的探讨转化生长因子-β1(TGF-β1)与胎盘生长因子(PLGF)在葡萄胎预后中的意义。方法收集180例葡萄胎患者,至少随访1年,其中30例发展为侵蚀性葡萄胎,1例发展为绒癌。采用免疫组化SV0002两步法检测33例正常早期妊娠(对照组)、33例未恶变葡萄胎(良性组)、31例恶变为妊娠滋养细胞肿瘤的葡萄胎(恶变组)的TGF-β1与PLGF的表达。结果恶变组TGF-β1阳性表达率(58.1%)低于对照组(97.0%)和良性组(87.9%),差异有统计学意义(P﹤0.05),对照组和良性组间差异无统计学意义(P﹥0.05);恶变组PLGF阳性表达率(90.3%)高于对照组(36.4%)和良性组(63.6%),差异有统计学意义(P﹤0.05),对照组和良性组间差异无统计学意义(P﹥0.05)。良性组和恶变组患者中年龄﹥40岁、人绒毛膜促性腺激素(h CG)﹥105U/L、子宫体积﹥孕周大小者TGF-β1阳性表达率均低于无上述高危因素者(P﹤0.05);卵巢黄素化囊肿直径﹥6 cm、重复性葡萄胎患者TGF-β1阳性表达率与无上述高危因素者比较,差异均无统计学意义(P﹥0.05)。良性组和恶变组患者中年龄﹥40岁、h CG﹥105U/L、子宫体积﹥孕周大小、卵巢黄素化囊肿直径﹥6 cm者的PLGF阳性表达率均高于无上述高危因素者(P﹤0.05);有无重复性葡萄胎者PLGF阳性表达率比较,差异无统计学意义(P﹥0.05)。良性组和恶变组中TGF-β1与PLGF表达均呈负相关(P﹤0.05)。结论 PLGF和TGF-β1可作为预测葡萄胎恶变的参考指标,联合葡萄胎恶变的高危因素,有助于葡萄胎恶变的预测。

Objective To explore the expressions of transforming growth factor beta 1 （TGF-β1） and placental growth factor （PLGF） in hydatidiform mole. Method A total of 180 cases of hydatidiform mole were followed for at least 1 year, in which 30 cases developed invasive hydatidiform mole, and 1 was choriocarcinoma. Immunohistochemical method was used to detect the expression levels of TGF-β1 and PLGF in 33 cases with early abortion （control group）, 33 cases with non-malignant hydatidiform mole （benign lesions group）, and 31 cases with invasive hydatidiform mole （ma-lignant lesions group）. Result The positive expression rates of TGF-β1 in invasive hydatidiform mole and choriocarcino-ma （58.1%） were significantly lower than that in benign lesions group （87.9%） and control group （97.0%） （P〈0.05）, while were similar between benign lesions and controls （P〉0.05）. As for PLGF, the patients with invasive hydatidiform mole and choriocarcinoma had higher positive expression rate （90.3%） than that in control group （36.4%） and benign lesions group （63.6%） （P〈0.05）, and it was comparable between benign lesions group and control group （P〉0.05）. Patients with age〉40 years, hCG〉105 U/L, and increased uterine volume had lower TGF-β1 expression （P〈0.05） in benign and malig-nant lesions group;patients with theca lutein cyst diameter〉6 cm or recurrent hydatidiform mole had similar positive ex-pression compared with those without the risk factors stated above （P〉0.05）. In benign and malignant lesions group, pa-tients with age〉40 years, hCG〉10^5 U/L, and increased uterine volume, or theca lutein cyst diameter〉6 cm had higher PLGF expression rate than those without （P〈0.05）;and those with or without recurrent hydatidiform mole had consistent PLGF levels （P〉0.05）. There was a negative correlation between TGF-β1 and PLGF expression in patients benign and malignant lesions （P〈0.05）. Conclusion TGF-β1 and PLGF may become a new index of predicting malignant transfor-mation of hydatidiform mole which provides a basis for preventive chemotherapy.