妊娠滋养细胞疾病中EMT相关蛋白CK-18、波形蛋白的表达及意义

目的 检测上皮细胞间质细胞转化（EMT）相关蛋白--细胞角蛋白18（CK-18）和波形蛋白（vimentin）在正常早孕绒毛、葡萄胎及妊娠滋养细胞肿瘤中的表达及与临床病理特征的关系。方法 采用免疫组化法（SP法）检测39例正常早孕绒毛组织、33例葡萄胎组织和32例妊娠滋养细胞肿瘤组织（侵袭性葡萄胎27例、绒毛膜癌5例）中CK-18、vimentin的定位及表达情况。结果 CK-18在各种类型滋养细胞中呈强阳性表达，正常绒毛组的CK-18表达水平高于葡萄胎组及妊娠滋养细胞肿瘤组，差异有统计学意义（P<0.01），葡萄胎组CK-18表达高于滋养细胞肿瘤组，差异有统计学意义（P<0.01）；vimentin于各组滋养细胞中呈弱阳性表达，各组间的表达差异无统计学意义（P>0.05）。在葡萄胎滋养细胞轻度增生组，CK-18蛋白的相对表达量高于滋养细胞中或重度增生组（P<0.01）。在滋养细胞肿瘤解剖学Ⅰ期组CK-18蛋白的相对表达量高于解剖学Ⅱ期及以上组（P<0.001）。结论 伴随着滋养细胞恶性度的升高CK-18的表达逐渐降低，提示EMT可能与滋养细胞的恶性转化有相关性。

The Expression of EMT Associated Protein CK-18 and Vimentin in Gestational Trophoblastic Disease

Objective To analyze the expression and clinicopathologic features of epithelial to mesenchymal transition (EMT) associated protein of cytokeratin-18 (CK-18) and vimentin in gestational trophoblastic disease (GTD).Methods Immunohistochemistry was used to determine theexpression of CK-18 and vimentin in normal pregnancy villis (39 cases), hydatidiform mole (HM) (33 cases) and gestational trophoblastic neoplasia (GTN) (invasive mole 27 cases and choriocarcinoma 5 cases). Results The GTN group had significantly lower levels of CK-18 compared with the normal pregnancy villis group and the HM group (P<0.01). Vimentin was weakly positive in all kinds of trophocyte. There was no significance among normal pregnancy villis,HM and GTN groups (P>0.05). In HM, expression level of CK18 was significantly lower with the increase of the pathological malignancy (P<0.01). And in GTN, the expression of CK-18 was significantly lower with the increase of the tumor anatomy stage (P<0.001). Conclusion The expression of CK-18 decreases with the increase of tropohblast malignancy, which indicates that CK-18 may be involved in malignant transformation of trophocytes and EMT may play an important role in the malignant transformation of GTN.