c-Ha-ras、c-erbB_2癌基因产物和p53、nm23抑癌基因产物对葡萄胎恶变的预测价值

目的：探讨ｃ－Ｈａ－ｒａｓ、ｃ－ｅｒｂＢ２癌基因产物和ｐ５３、ｎｍ２３抑癌基因产物表达异常和葡萄胎恶变的关系及在预测葡萄胎恶变的价值。方法：采用针对４种基因产物的单克隆抗体，ＳＰ法免疫组织化学染色，回顾分析了≥２ａ随访证实发生恶变的葡萄胎５０例（恶变组）和未发生恶变的葡萄胎３２例（非恶变组）中４种基因产物的表达情况。结果：恶变组中ｃ－Ｈａ－ｒａｓ和ｎｍ２３基因产物的表达程度显著低于非恶变组（Ｐ＜０．０１，Ｐ＜０．００１）；恶变组中ｃ－ｅｒｂＢ２及ｐ５３基因产物的表达程度显著高于非恶变组（Ｐ＜０．０１，Ｐ＜０．０５）。进一步以４种基因产物的表达程度为变量，进行ｌｏｇｉｓｔｉｃ回归判别分析，表明４种基因产物联合应用对葡萄胎恶变的预测敏感性率为８６％，特异性率为７８．１％，而ｌｏｇｉｓｔｉｃ逐步回归判别分析显示，ｃ－ｅｒｂＢ２和ｎｍ２３基因产物联合应用时，对葡萄胎恶变的预测敏感性率为８４％，特异性率为７５％。结论：ｃ－Ｈａ－ｒａｓ、ｃ－ｅｒｂＢ２癌基因产物及ｐ５３、ｎｍ２３抑癌基因产物表达异常与葡萄胎恶变密切相关，用以预测葡萄胎恶变具有较高的价值

The predicting evaluation of c Ha ras,c erbB 2,p53 and nm23 gene products in the malignant transformation of hydatidiform mole.

Objective:To evaluate the prediction of c Ha ras,c erbB 2,p53 and nm23 gene products in the malignant transformation of hydatidiform mole.Methods:Retrospective study of the expression of c Ha ras,c erbB 2,p53 and nm23 genes were performed in 50 cases of malignant transforming hydatidiform mole(malignant transforming group,MTG)and 32 cases of non malignant transforming mole(non malignant transforming group,NMTG).Fromalin fixed,paraffin embedded histological sections were used for immunohistochemistry,untilizing monoclonal antibodies to c Ha ras,c erbB 2,p53 and nm23 gene products logistic estimate study was also used to analyze the predicting evaluation of the four gene products in MTG.Results:The expression of c erbB 2 and p53 gene products were significantly elevated in MTG than that in NMTG( P <0.01, P <0.05),while the expression of c Ha ras and nm23 gene products were significantly reduced in MTG( P <0.01, P <0.0001).Furthermore,with the expression of the four gene products as variance for logistic estimate analysis showed that the predicting sensistvity rate of combined use of the four gene products in TMG was 86%,the specificity rate was 78.1%,meanwhile the predicting sensitvity rate of combined use of c erbB 2 gene products was 84%,the predicting specificity rate was 75%.Conclusion:Altered expressions of oncogenes c Ha ras,c erbB 2,and suppressor genes p53 and nm23 gene products are correlated with malignant changes of hydatidiform mole and have high predicting evaluation in the malignant transformation of hydatidiform mole.