基质金属蛋白酶-2在妊娠滋养细胞疾病中的表达及意义

目的:探讨基质金属蛋白酶-2(m atrix m etalloprote inase,MMP-2)在妊娠滋养细胞疾病中的表达。方法:应用免疫组化SP法检测正常早孕妇女胎盘绒毛10例、葡萄胎20例、侵蚀性葡萄胎32例及绒毛膜癌16例组织中MMP-2的表达情况。结果:MMP-2主要表达于合体滋养细胞、绒毛外滋养细胞。正常早孕绒毛组织、妊娠滋养细胞疾病组织中,MMP-2均有阳性表达,早孕绒毛与早孕期葡萄胎间有显著差异(P<0.05),与葡萄胎病理分型、胎次无相关性,早孕期葡萄胎MMP-2阳性表达率显著高于晚孕期葡萄胎(P<0.05)。正常绒毛组MMP-2阳性表达率与葡萄胎组、侵蚀性葡萄胎组和绒毛膜癌组相比有显著性差异(P<0.05)且有逐渐上升趋势,但其余各组间无统计学意义。MMP-2表达与侵蚀性葡萄胎、绒毛膜癌临床分期无相关性。侵蚀性葡萄胎组中未化疗者MMP-2阳性表达率显著高于化疗者(P<0.05);绒毛膜癌组中未化疗组MMP-2阳性表达率高于化疗组,但无统计学意义。结论:MMP-2与滋养细胞的浸润活性呈正相关,与孕周呈负相关,可能与正常滋养细胞浸润行为的时空阶段性和限制性有关。随着妊娠滋养细胞疾病恶性程度升高MMP-2逐渐呈强表达,化疗后其阳性表达明显下降,提示MMP-2可能作为临床早期诊断妊娠滋养细胞疾病、判断治疗疗效及预后的重要指标之一。

The expression of matrix metalloproteinase (MMP-2) in gestational trophoblastic disease (GTD)

Objective:To investigate the expression and detecte the significance of matrix metalloproteinase(MMP-2) in normal villi and gestational trophoblastic disease(GTD).Methods: Using immunohistochemical S-P method to detect the expression of MMP-2 in 10 cases normal villi,hydatiform mole 20 cases,invasive mole 32 cases and choriocarcinoma 16 cases respectively.Results: MMP-2 mainly expressed in syncytio-and extrovillous trophoblast.The expression of MMP-2 could be detected in both of normal villi and GTD tissues,but the positive ratio of expression was higher in GTD(P<0.05),the expression intensity was different significantly between normal villi and early trimester hydatiform mole(P<0.05),the expression rate was not related to hydatiform mole pathological type and gestational sequence.The positive ratio of MMP-2 was significantly higher in first trimster than in second or third trimester hydatiform mole.There was no any association between the expression of MMP-2 and clinical stage for invasive mole or choriocarcinoma.The positive ratio of MMP-2 was significantly higher in invasive mole cases treated without chemotherapy than the cases with chmeotherapy(P<0.05),and it was higher in choriocarinoma cases with chemotherapy than without chemotherapy,but there was no significantly difference.Conclusion: The expression of MMP-2 was positively related to the invasive activity of trophoblast cell,and negatively related to the gestational weeks,this phenomena might be associated with time-space phase character and life longevity of normal villi's invasiveness.The expression of MMP-2 become more and more intensively with the advance progress of GTD,the intensity of expression is decreased dramatically after chemotherapy,it was demonstrated that MMP-2 could be as an important diagnostic and prognostic marker for GTD treatment.