| CD44V6、基质金属蛋白酶-9、p57^kip2罐及人类绒毛膜促性腺激素在葡萄胎中的表达及意义 |
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| 引用本文： | 陈英,秦燕,张荣华,孙彦青. CD44V6、基质金属蛋白酶-9、p57^kip2罐及人类绒毛膜促性腺激素在葡萄胎中的表达及意义[J]. 肿瘤研究与临床, 2011, 23(6): 384-387. DOI: 10.3760/cma.j.issn.1006-9801.2011.06.007 |
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| 作者姓名： | 陈英 秦燕 张荣华 孙彦青 |
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| 作者单位： | 1. 日照市人民医院检验科,276826
2. 日照市人民医院产二科,276826 |
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| 摘 要： | 目的分析CD44V6、基质金属蛋白酶（MMP）-9、p57＾kip2及人类绒毛膜促性腺激素（hCG）的表达在葡萄胎诊断、鉴别诊断及生物学行为预测中的价值。方法采用免疫组织化学SP法检测55例葡萄胎组织、20例流产伴绒毛水肿、10例正常胎盘绒毛中CD44v6 MMP-9、p57^kip2的表达；采用化学发光法测定患者hCG水平。分析CD44v6、MMP-9、p57^kip2及hCG对鉴别诊断完全性、部分性葡萄胎及绒毛水肿的价值及对判断葡萄胎恶变的意义。结果55例葡萄胎中恶变9例，未恶变46例；葡萄胎恶变组与未恶变组CK44v6、MMP-9、p57^kip2的表达（77．8％比30．4％，77．8％比34．8％，11．1％比58．7％）差异有统计学意义（均P〈0．05）；完全性与部分性葡萄胎组中p57^kip2的表达（5．0％比100．0％）差异有统计学意义（P〈O．05），而CD44v6、MMP-9的表达差异无统计学意义（P〉0．05）；葡萄胎组、流产伴绒毛水肿组、正常胎盘绒毛组组问比较，CD44v6、MMP-9、p57kip2的表达差异均无统计学意义（P〉0．05）；在葡萄胎恶变组血hCG4例持续阳性、5例降而复升；对部分性葡萄胎p57啦诊断的敏感度为100．0％，特异度95．0％，阴性预测值100．0％。单项检测CD44v6。对诊断葡萄胎恶变的敏感度为77．8％，特异度69．6％，阴性预测值94．1％；MMP-9的敏感度为77．8％，特异度为65．2％，阴性预测值为93．8％；而CD44v6和MMP-9两项联合检测敏感度达88．9％，阴性预测值96．3％，CD44v6、MMP-9和hCG三者结合，可使诊断敏感性、阴性预测值明显提高。结论 p57^kip2啦结合组织学对鉴别完全性与部分性葡萄胎有价值；CD44v6和MMP-9在葡萄胎恶变过程中起重要作用，联合检测DD44v6、p57^kip2、MMP-9及hCG有助于判断葡萄胎的生物学行为和预后。
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| 关 键 词： | 葡萄胎 细胞黏附分子 周期素依赖激酶抑制剂p57 基质金属蛋白酶 绒毛膜促性腺激素 |
Expression and clinical significance of CD44V6, MMP-9, p57kip2 and hCG in hydatidiform mole |
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| CHEN Ying,QIN Yan,ZHANG Rong-hua,SUN Yan-qing. Expression and clinical significance of CD44V6, MMP-9, p57kip2 and hCG in hydatidiform mole[J]. Cancer Research and Clinic, 2011, 23(6): 384-387. DOI: 10.3760/cma.j.issn.1006-9801.2011.06.007 |
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| Authors: | CHEN Ying QIN Yan ZHANG Rong-hua SUN Yan-qing |
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| Affiliation: | . Department of Clinical Laboratory, Affiliated Rizhao People＇s Hospital of Jining Medical College, Rizhao 276826, China |
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| Abstract: | Objective To investigate the prognostic value of CD44V6, MMP-9, p57kip2 and hCG in diagnosis differential diagnosis and malignant transformation of hydatidiform mole. Methods The expressions of CD44V6 MMP-9 and p57kip2 was detected by SP method and the serum hCG was detected with CLIA method in 55 cases of hydatidiform mole, 20 cases of abortion villi and 10 cases of normal villi, and the value of CD44V6, MMP-9, p57kip2 and hCG in diagnosis differential diagnosis and malignant transformation of hydatidiform mole was analyzed. Results There were 9 cases malignant transforming hydatidiform mole and 44 cases of non-malignant transforming hydatidiform mole(20 cases of complete hydatidiform mole, 26 cases of partial hydatidiform mole). The expression of CD44V6 MMP-9 and p57kip2 of malignant transforming mole was significantly higher than that of non-malignant transforming group (77.8 % vs 30.4 %, 77.8 % vs 34.8 %, 11.1 % vs 58.7 %) (P <0.05) and the expression difference of p57kip2 in complete mole and partial mole group (5.0 % vs 100.0 %) was statistically significant (P <0.05). HCG remained positive in 4 cases of hydatidiform mole and dropping and then rised in 5 cases. The sensitivity of p57kip2 in the diagnosis of partial hydatidiform mole was 100.0 %, the specificity was 95.0 %, the negative prediction was 100.0 %. The sensitivity of CD44V6 in the diagnosis of malignant hydatidiform mole was 77.8 %, specificity was 69.6 %, negative prediction was 94.1 %;The sensitivity of MMP-9 was 77.8 %, specificity was 65.2 %, negative prediction was 93.8 %. The sensitivity of the two combined detection (CD44V6 and MMP-9) was 88.9 %, negative prediction was 96.3 %. The sensitivity of combined detection (CD44V6, MMP-9 and hCG) was higher than any of them. Conclusion p57kip2 is an important marker in differential diagnosis of hydatidiform mole. CD44V6, MMP-9 play important roles in the process of transformation of hydatidiform mole. The combined detection of CD44V6, MMP-9, p57kip2 and hCG can help to diagnosis and differential diagnosis and predict biological behaviors and prognosis of hydatidiform mole. |
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| Keywords: | Hydatidiform mole Vascular cell adhesion molecule Cyclin-dependent kinase inhibitor p57 Matrix metalloproteinase-9 Chorionic gonadotropin |
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