CXCL10和MMP-13在妊娠滋养细胞疾病滋养细胞中的表达及其临床意义

Expression of CXCL10 and MMP-13 in the trophoblast cells of gestational trophoblastic disease and its clinical significance

目的检测妊娠滋养细胞疾病滋养细胞中CXCL10和MMP-13表达情况,探讨其在滋养细胞疾病浸润和转移中的作用。方法采用免疫组织化学Powervision法检测40例早孕绒毛,30例葡萄胎,18例葡萄胎恶变(随访发生恶变),35例滋养细胞肿瘤(28例绒癌,7例胎盘部位滋养细胞肿瘤)中CXCL10和MMP-13的表达。结果CXCL10和MMP-13在滋养细胞肿瘤中表达阳性率和免疫反应性强度最高;在葡萄胎恶变组中表达阳性率和免疫反应性强度较高,但是低于在滋养细胞肿瘤中的表达阳性率和免疫反应性强度;在葡萄胎组和早孕绒毛组中表达阳性率和免疫强度较低。CXCL10和MMP-13在滋养细胞肿瘤中的表达,年龄<40岁组中表达低于年龄>40岁组;在临床分期分组(Ⅰ、Ⅱ)中表达低于临床分期分组(Ⅲ、Ⅳ);在FIGO预后评分分组低危组中表达低于高危组。结论CXCL10和MMP-13在早孕绒毛组织中低表达,而在滋养细胞肿瘤中高表达,提示其可能参与滋养细胞疾病的浸润和转移过程,因此联合检测CXCL10和MMP-13的表达可能对葡萄胎恶变的早期诊断以及对滋养细胞肿瘤的预后评估提供依据。

Objective To detect the expression of CXCL10 and MMP-13 in the trophoblast cells of gestational trophoblastic disease, and explore its role in the invasion and metastasis of gestational trophoblastic disease. Methods The expression of CXCL10 and MMP-13 was detected by immunohistochemistry in 40 cases of normal chorionic villi in early pregnancy, 30 of cases hydatidiform mole, 18 cases of hydatidiform mole with malignant transformation (during follow-up) and 35 cases of gestational trophoblastic tumors (28 cases of choriocarcinoma, 7 cases of placental site trophoblastic tumors). Results The positive expression rate and immunoreactivity intensity of CXCL10 and MMP-13 were highest in the group of trophoblastic tumors and also relatively high in the group of hydatidiform mole with malignant transformation though lower than those in trophoblastic tumors, however, the positive expression rate and immunoreactivity intensity were relatively low in the groups of hydatidiform mole and normal chorionic villi. In addition, there was lower expression of CXCL10 and MMP-13 in the group of age less than 40 years old compared to the group of age over 40 years old. And there was lower expression of CXCL10 and MMP-13 in clinical stage I and Ⅱ compared to in clinical stage Ⅲ and IV. And there was lower expression of CXCL10 and MMP-13 in FIGO prognostic score (low risk) compared to FIGO prognostic score (high risk) of gestational trophoblastic tumors. Conclusion The expression of CXCL10 and MMP-13 was higher in gestational trophoblastic tumors than in normal chorionic villi, suggesting that CXCL10 and MMP-13 might be involved in the invasion and metastasis of gestational trophoblastic disease. Therefore, combined examination of CXCL10 and MMP-13 may provide the evidence for not only the early diagnosis of hydatidiform mole malignant transformation but also the evaluation of the prognosis of gestational trophoblastic tumors.