癌基因、妊娠性滋养细胞增生与葡萄胎恶变关系的研究

目的：探讨癌基因、妊娠性滋养细胞增生程度与葡萄胎恶变的关系。方法：采用针对Ｃ－Ｈａ－ｒａｓ及Ｃ－ｅｒｂＢ２基因表达产物Ｐ２１和Ｐ１８５的单克隆抗体进行免疫组织化学染色。检测８２例葡萄胎中两种基因产物的表达情况，经２年以上随访证实未发生恶变３２例为非恶变组，经手术和临床证实发生恶变５０例为恶变组，其中３５例行手术治疗。结果：恶变组Ｐ２１的表达程度低于非恶变组（Ｐ＝０．００８２）；Ｐ１８５的表达显著高于非恶变组（Ｐ＝０．００２８）。手术治疗的３５例中，恶变后两种基因产物的表达改变较恶变前更明显。两组葡萄胎中滋养细胞增生程度差异无显著性（Ｐ＝０．４１３）。不同来源的绒毛膜癌（绒癌）之间及绒癌与侵蚀性葡萄胎（侵葡）之间，Ｐ２１和Ｐ１８５的表达差异亦无显著性（Ｐ＝０．２６８，Ｐ＝０．７１９）。结论：Ｐ２１的低表达及Ｐ１８５的高表达与葡萄胎恶变有关，但与其恶性转化方向无关；滋养细胞增生程度与葡萄胎恶变亦无关。

Study on the role of oncogenes and gestational trophoblastic cell proliferative activity in malignant transformation of hydatidiform mole.

Objective To study the effects of c Ha ras,c erbB 2 oncogenes and gestational trophoblastic cell proliferative activity in the malignant transformation of hydatidiform mole. Methods c Ha ras and c erbB 2 oncogenes expressions and cell proliferative activities were evaluated in 82 cases of hydatidiform mole,including 32 cases of benign and 50 cases of malignant transforming hydatidiform mole.Formalin fixed,paraffin embedded histological sections were used for immunohistochemistry,utilizing the streptavidin peroxdase conjugated method,and monoclonal antibodies to p 21 ras and p 185 c erbB 2 oncoproteins. Results The expression of p 185 was highly elevated in malignant transforming group than that in benign group( P =0.0028),but the expression of p 21 was significantly reduced in this group too( P =0.027).There was no difference in both genes expressions between choriocarcinomas of different origin and between choriocarcinoma and invasive hydatidiform mole.Cell proliferative activity was not significantly different in both groups. Conclusion Elevated expression of c erbB 2 oncoprotein and reduced expression of c Ha ras oncoprotein may play roles in the malignant transformation of hydatidiform mole,but cell proliferative activity has no effect in this transformation.