葡萄胎恶变相关因素的探讨及基质金属蛋白酶-9在妊娠滋养细胞疾病中表达的临床意义

目的 通过测定基质金属蛋白酶(MMP)-9在不同类型滋养细胞疾病中的表达,探讨其预测葡萄胎恶变和转移的可能性;并对葡萄胎恶变相关因素进行分析,以提高对葡萄胎预后的判断.方法 应用链霉菌抗生物素蛋白,过氧化物酶免疫组织化学方法 对30例正常早孕(＜12周)绒毛组织、32例部分性葡萄胎、93例完全性葡萄胎、30例侵蚀性葡萄胎、5例绒毛膜癌组织中MMP-9进行检测.分析7例发生恶变的葡萄胎患者的发病年龄、子宫大小、卵巢黄素囊肿、血β-人绒毛膜促性腺激素(hCG)等因素.结果 MMP-9在正常早孕绒毛组织、部分性葡萄胎、完全性葡萄胎、侵蚀性葡萄胎、绒毛膜癌组织中均有表达,但随着滋养细胞疾病恶性程度的增加,其表达强度显著升高(X2=23.49,P＜0.05).结论 MMP-9与正常早孕滋养细胞的侵袭过程有关,MMP-9在滋养细胞疾病组织中表达的强度,与滋养细胞恶性程度的强度有关,对临床早期预测葡萄胎的恶变及预防性化疗有一定的参考意义.葡萄胎恶变还与患者发病年龄、β-hCG水平、子宫大小、卵巢黄素囊肿等因素有关.

Correlative factors of the hydatidiform mole deterioration and clinical significance of matrix metalloproteinase 9 in gestational trophoblastic disease

Objective To discuss the possibility of prognosing the hydatidiform mole deterioration and metastasis by detecting the expression of matrix metalloproteinase 9(MMP-9)in different type of trophoblastic disease,and analyze the correlative factors of the hydatidiform mole deterioration,so as to improve the criterion of hydatidiform mole prognosis.Methods The expression of MMP-9 in 30 cases of normal human(Iess than 12 weeks)cytotrophoblast cells,32 cases of partial hydatidiform mole,93 cases of complete hydatidiform mole,30 cages of invasive mole and 5 cases of choriocarcinoma were detected by immunohistochemical streptavidin-pemxidase.The factors as the age of onset,uterine size,luteinizing cyst,β-human chorionic gonadotropin hCG of 7 cases of the hydatidiform mole deterioration were analyzed.Results The expression of MMP-9 was detected in all types of trophoblastic cells,with the development of the malignant transformation the stainning Was markedly increased in the invasion of the normal human cytotrophoblast cells(X2=23.49,P＜0.05).Conclusion The difference of MMP-9 expressin gestational trophoblasts is helpful to predict the hydatidiform mole deterioration and metastagis,the hydatidiform mole deterioration correlates with the age of onset,β-hCG,uterine size,luteinizing cyst.