TGF-β1和PLGF在不同类型妊娠滋养细胞疾病患者病变组织中的表达及其意义

Expressions of TGF-β1 and PLGF in tissue of patients with different types of gestational trophoblastic diseases and their significances

目的:检测不同类型妊娠滋养细胞疾病患者病变组织中转化生长因子β1(TGF-β1)和胎盘生长因子(PLGF)的表达,阐明其在不同妊娠滋养细胞疾病中意义。方法:收集葡萄胎组织40例(葡萄胎组)、妊娠滋养细胞肿瘤组织26例(GTN组,包括侵蚀性葡萄胎22例和绒毛膜癌4例)和正常早孕绒毛组织40例(正常对照组)作为研究对象。采用免疫组织化学法检测不同组织中TGF-β1和PLGF的阳性表达率,分析TGF-β1和PLGF在正常对照组、葡萄胎组和GTN组患者中的表达差异以及其与患者临床高危因素(年龄>40岁、子宫体积>孕周和卵巢黄素化囊肿直径>6cm)的关联性。结果:与正常对照组(87.5%)比较,葡萄胎组(62.5%)和GTN组(30.8%)TGF-β1阳性表达率明显降低(P<0.05);且葡萄胎组TGF-β1阳性表达率高于GTN组(P<0.05)。与正常对照组(22.5%)比较,葡萄胎组(50.0%)和GTN组(80.8%)PLGF阳性表达率明显升高(P<0.05),且葡萄胎组PLGF阳性表达率低于GTN组(P<0.05)。与正常对照组比较,葡萄胎组患者中年龄>40岁、子宫体积>孕周、卵巢黄素化囊肿直径>6cm者TGF-β1阳性表达率明显降低(P<0.05),而PLGF阳性表达率明显升高(P<0.05)。在GTN组中并发高危因素者较无高危因素者TGF-β1阳性表达率明显降低(P<0.05),而PLGF阳性表达率明显升高(P<0.05)。葡萄胎组和GTN组患者TGF-β1与PLGF阳性表达水平均呈负相关关系(r=-0.585,P<0.05;r=-0.479,P<0.05)。结论:TGF-β1在葡萄胎和妊娠滋养细胞肿瘤组织中阳性表达逐渐降低,PLGF表达率逐渐升高,可能与妊娠滋养细胞疾病患者的不同类型及预后有关。

Objective:To detect the expressions of transforming growth factor-β1(TGF-β1)and placental growth factor(PLGF)expressions in the tissue of the patients with different types of gestational trophoblastic diseases,and to clarfy the significances of their expressions in different types of gestational trophoblastic diseases.Methods:A total of 40 cases of hydatidiform mole tissue(hydatidiform mole group)and 26 cases of gestational trophoblastic tumour tissue(GTN group,including 22 cases of invasive hydatidiform mole and 4 cases of choriocarcinoma),and 40 cases of normal early pregnancy villi(normal control group)were collected.Immunohistochemical method was used to detect the positive expression rates of TGF-β1 and PLGF,the differences of TGF-β1 and PLGF expressions between normal group,hydatidiform mole group and GTN group were analyzed,and the associations between them and the clinical high risk factors(age>40 years old,the uterine volume>gestational age,and thecalutein ovarian cyst diameter>6 cm)were analyzed.Results:The positive expression rates of TGF-β1 in hydatidiform mole group(62.5%)and GTN group(30.8%)were lower than that in normal group(87.5%)(P<0.05);the positive expression rates of TGF-β1 in hydatidiform mole group was higher than that in GTN group(P<0.05).The positive expression rates of PLGF in hydatidiform mole group(50.5%)and GTN group(80.8%%)were higher than that in normal control group(22.5%%);the positive expression rate of PLGF in hydatidiform mole group was lower than that in GTN group(P<0.05).The positive expression rates of TGF-β1 of the patients in hydatidiform mole group with the age>40 years old,the uterine volume>the gestational age,and the ovarian luteinized cyst diameter>6 cm were significantly decreased(P<0.05)and the positive expression rates of PLGF were significantly increased(P<0.05)compared with normal control group.The positive expression rate of TGF-β1 of the patients in GTN group with the high risk factors was significantly decreased compared with those without the high risk factors(P<0.05)and the positive expression rate of PLGF was significantly increased(P<0.05).In hydatidiform mole group and GTN group,there were moderately negative correlations between the positive expression rates of TGF-β1 and PLGF(r=-0.585,P<0.05;r=-0.479,P<0.05).Conclusion:The expression levels of TGF-β1 in hydatidiform mole and gestational trophoblastic tumor are gradually decreased,and the expression levels of PLGF are gradually increased,which may be related to the different types and prognosis of gestational trophoblastic diseases.