葡萄胎的受精类型与恶变的关系

目的:探讨葡萄胎不同受精形式和临床转归的关系.方法:用9个位点(F13A01、FESFPS、VWA、CSF1P0、TPOX、TH01、D16S539、D7S820、D13S317)复合STR-PCR方法对54例葡萄胎病例进行分析,区分受精类型;通过追踪病人刮宫后血绒毛膜促性腺激素(human chorionic gonadotropin,hCG)变化判断葡萄胎是否恶变.结果:54例葡萄胎病例中10例恶变,占19%(10/54).54例中38例为DNA完全来自父方的"遗传学完全性葡萄胎",恶变均发生于这些病例中,占26%(10/38):空卵单精子受精的"纯合性"葡萄胎28例,恶变8例,占29%(8/28);空卵双精子受精的"杂合性"葡萄胎10例,恶变2例,占20%(2/10).DNA来自双亲的单倍体卵子双精子受精的"遗传学部分性葡萄胎"16例,无恶变发生.结论:DNA完全来自父方的"遗传学完全性葡萄胎"比DNA来自双亲的"遗传学部分性葡萄胎"易于恶变(P=0.024 2),而前者的恶变发生与其"纯/杂合性"无关(P=0.699).

The relationship between malignant transformation and fertilization types of hydatidiform moles

Objective: To study the relationship between malignant transformation and fertilization types of hydatidiform moles (HM). Methods: Fifty four HM specimens were analyzed by using multiplex STR-PCR (9 loci) to determine the fertilization types and all patients were followed up for the human chorionic gonadotropin (hCG) over 1 year. Results: Total malignant transformation cases were 10 in all the 54 HM. Ggenetics complete hydatidiform moles (g CHM),with DNA from only paternal origin, were observed in 38 cases including 28 homozygote and 10 heterozygote cases. In homozygote and heterozygote cases,malignant transformation occurred in 8 cases of the empty eggs fertilized by single sperms and 2 by double sperms respectively.In all the 54 HMs, 16 cases of DNA from parents were genetic partial hydatidiform moles (g PHM), and no malignant transformation occurred in each haploidy egg fertilized by double sperms. Conclusion:(1)Genetic complete hydatidiform moles (g CHM) showed a higher malignant transformation risk than genetic partial hydatidiform moles (g PHM) (P =0.024 2);(2)There was no significant difference in malignant transformation between homozygote and heterozygote of g CHM ( P =0.699).