c-erbB2、nm23-H1在妊娠滋养细胞疾病中的表达及其临床意义

Expression of c-erbB2 and nm23-H1 in Gestational Trophoblastic Disease and Its Clinical Significance

目的 :探讨癌基因c erbB2和抑癌基因nm2 3 H1在妊娠滋养细胞肿瘤的临床分期及临床主要预后因素不同的情况下表达的差异 ,以期达到对妊娠滋养细胞疾病转归的预测。方法 :采用针对两种基因表达产物的单克隆抗体进行SABC免疫组织化学染色 ,回顾性检测分析 30例不同妊娠期正常胎盘、2 1例葡萄胎、2 1例侵蚀性葡萄胎及 2 0例绒癌中两种基因产物的表达情况。结果 :c erbB2基因在侵蚀性葡萄胎和绒癌中的表达明显高于葡萄胎及妊娠中晚期正常胎盘 ,而nm2 3 H1的表达明显低于葡萄胎及妊娠中晚期正常胎盘 (P <0 0 5 ) ;c erbB2基因在临床Ⅲ、Ⅳ期患者中的表达高于Ⅰ、Ⅱ期患者 ,但差异无统计学意义 ;nm2 3 H1基因产物的高表达与WHO预后评分系统的好的预后因素相一致。结论 :c erbB2的高表达及nm2 3 H1的低表达与葡萄胎恶变紧密相关 ,对于妊娠滋养细胞肿瘤的早期诊断、早期治疗及预后评估具有重要的临床意义。

Objective:To study the expression of c-erbB2 and nm23-H1 gene products in gestational trophoblastic tumors (GTT) associated with its clinical staging and main prognostic factors, and to prognosticate the malignant transformation of gestational trophoblastic disease (GTD). Methods:21 hydatidiform mole, 21 invasive hydatidiform mole, 20 choriocarcinoma, and 30 normal placenta of different pregnant trimester were detected these two genes by immunohistochemistry in this retrospective study. Results:Expression of c-erbB2 gene was significantly elevated in GTT than that in hydatidiform mole and normal placenta in moderate and advanced pregnancy, while expression of nm23-H1gene was significantly reduced (P<0.05). Furthermore, expression of c-erbB2 in GTT patients with stage Ⅱ and Ⅳ was higher than that of stage Ⅰ and Ⅱ, and there was no statistical significance. Low-expression of nm23-H1 was consistent to the poor prognosis of WHO prognostic scoring system. Conclusions:Over-expression of c-erbB2 and low-expression of nm23-H1 may closely correlated with more aggressive behavior in GTD, and they may not only provide important insights into pathogenesis but also be useful in guiding early diagnosis and therapy.