滋养叶细胞增殖基因及间质细胞凋亡检测在水泡状胎块诊断中的价值

目的探讨滋养叶细胞增殖相关基因及间质细胞凋亡检测在水泡状胎块（HM）病理诊断中的价值。方法应用免疫组织化学标记技术，检测100 例HM（其中完全性HM 61 例，部分性HM 39 例）及40 例绒毛水肿的病理组织标本滋养叶细胞的Ki67、Livin与Bcl-2 的表达，并应用TUNEL法对绒毛间质凋亡细胞进行原位观察。结果Ki67 阳性表达在绒毛水肿组、部分性HM 组、完全性HM 组趋势呈逐渐增强，各组间比较均差异有统计学意义（P <0.05）；绒毛水肿组及HM 组绒毛间质内AI指数比较，差异有统计学意义（P <0.05）；Livin 及Bcl-2 表达差异无统计学意义（P >0.05）；Ki67 表达与AI 指数呈正相关（P <0.05）。结论间质细胞凋亡联合滋养叶细胞中Ki67 表达检测可用于HM的诊断与分型，也可用于鉴别HM 与绒毛水肿。

Value of trophoblastic cell proliferation-related gene and interstitial cell apoptosis in diagnosis of hydatidiform moles

Objective To investigate the value of trophoblastic cell proliferation-related gene and interstitial cell apoptosis in the diagnosis of hydatidiform moles. Methods Immunohistochemical technique was used to detect the expressions of Ki67, Livin and Bcl-2 in trophoblast cells. TUNEL was used to detect apoptosis of villous stroma cells of 100 cases of hydatidiform moles (including 61 cases of complete hydatidiform moles and 39 cases of partial hydatidiform moles) and 40 cases of villous edema. Results The expression of Ki67 in the trophoblastic cells of the villous edema group, partial hydatidiform mole group and complete hydatidiform mole group gradually increased, the differences among the 3 groups were statistically significant (P < 0.05). There were no significant differences in the expression of Livin or Bcl -2 among the 3 groups (P > 0.05). There was a positive correlation between Ki67 expression and AI index (P < 0.05). Conclusions The detection of Ki67 expression in trophoblastic cells and apoptosis in villous stroma cells can be used for the diagnosis and classification of villous edema, partial hydatidiform mole and complete hydatidiform mole.