妊娠滋养细胞疾病组织中HIF-1α、ANG-1及p53蛋白水平变化及预测葡萄胎恶变

Changes of the levels of hypoxia inducible factor-1α,angiopoietin-1,and p53 protein in gestational trophoblastic disease tissues and their predictive efficacy for the malignant transformation of hydatidiform mole

目的:分析妊娠滋养细胞疾病组织中缺氧诱导因子-1a(HIF-1α)、血管生成素-1(ANG-1)及p53蛋白水平变化及对葡萄胎恶变的预测效能。方法:收集2018年1月-2021年1月本院诊治的妊娠滋养细胞疾病患者88例为病例组,正常早孕流产接受刮宫治疗患者88例为对照组,比较绒毛组织中HIF-1α、ANG-1及p53蛋白水平并分析对葡萄胎恶变的预测效能。结果:病例组HIF-1α、ANG-1及p53蛋白相对表达水平均高于对照组,且在病例组中绒毛膜癌、侵袭性葡萄胎、葡萄胎绒毛组织上述指标水平有差异(均P<0.05)。3项指标联合检测诊断绒毛膜癌、侵袭性葡萄胎特异度(58.1%、54.8%)高于单独指标检测。通过受试者工作特征曲线分析,HIF-1α、ANG-1及p53诊断侵袭性葡萄胎和绒毛膜癌的曲线下面积分别为0.909、0.998,诊断临界值分别为1.88、2.91、2.61,2.89、3.77、3.30。结论:妊娠滋养细胞疾病组织中HIF-1α、ANG-1及p53蛋白水平发生异常变化,联合检测对葡萄胎恶变有一定预测价值。

Objective:To study the changes of the levels of hypoxia inducible factor 1α(HIF-1α),angiopoietin-1(ANG-1),and p53 protein levels in gestational trophoblastic disease tissues of women,and to study their predictive efficacy for the malignant transformation of hydatidiform mole of the women.Methods:88 women with gestational tropho-blastic disease diagnosed and treated in hospital were selected in study group,and 88 normal pregnant women with abortion and curettage during early pregnancy were selected in control group from January 2018 to January 2021.The levels of HIF-1α,ANG-1,and p53 protein in gestational trophoblastic disease tissues of the women were compared between the two groups,and the predictive efficacy of which for the malignant transformation of hydatidiform mole of the women was analyzed.Results:The relative expression levels of HIF-1α,ANG-1,and p53 protein of the women in the study group were significantly higher than those of the women in the control group.The expressions levels of HIF-1α,ANG-1,and p53 protein in choriocarcinoma tissue,in invasive hydatidiform mole tissue,and in hydatidiform mole tissue of the women in the study group had significantly different(all P<0.05).The specificity of the combined levels of HIF-1α,ANG-1,and p53 protein of the women for diagnosing their choriocarcinoma or invasive hydatidiform mole was 58.1%or 54.8%,which was significantly higher than that of HIF-1 alevel,ANG-1 level,or p53 protein level alone.The areas under receiver operating characteristic(ROC)curve of the levels of HIF-1α,ANG-1,and p53 protein of the women for diagnosing their invasive hydatidiform mole and choriocarcinoma were 0.909 and 0.998.The critical values of HIF-1αlevel,ANG-1 level,and p53 protein level of the women for diagnosing their invasive hydatidiform mole or choriocarcinoma were 1.88 or 2.91,2.61 or 2.89,and 3.77 or 3.30,respectively.Conclusion:The changes of HIF-1α,ANG-1,and p53 protein levels in gestational trophoblastic disease tissues of the women are abnormal,and the combined detections of HIF-1α,ANG-1,and p53 protein levels of the women have certain predictive value for the malignant transformation of hydatidiform mole of the women.