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目的 探讨 p16、CyclinD1基因在滋养细胞肿瘤发生方面的意义。方法 用免疫组化SP法 ,对 49例滋养细胞疾病组织 (葡萄胎首次清宫标本 32例 ,侵蚀性葡萄胎及绒癌子宫标本分别为 12例和 5例 )和 4例早孕正常绒毛组织中p16和CyclinD1进行检测。结果 在早孕绒毛组织中 ,p16和CyclinD1表达分别为全部阳性和全部阴性。在不恶变葡萄胎、以后发生恶变的葡萄胎和滋养细胞肿瘤中p16表达呈下降趋势 ,CyclinD1表达呈上升趋势。p16和CyclinD1表达阳性率在不恶变葡萄胎与以后发生恶变的葡萄胎组间、在不恶变葡萄胎组与侵蚀性葡萄胎间均有显著差异 (P <0 0 5 ) ;而以后发生恶变的葡萄胎与侵蚀性葡萄胎间及侵蚀性葡萄胎与绒毛膜癌间无显著差异 (P >0 0 5 )。结论 p16表达缺失、CyclinD1过表达可能在滋养细胞恶性转化、侵蚀性葡萄胎发生中起重要作用。检测葡萄胎首次清宫标本 p16及CyclinD1表达 ,可能在判断葡萄胎预后方面具有重要意义
Objective To investigate the significance of p16 and CyclinD1 in trophoblastic tumor. Methods Immunohistochemical SP method was used to detect the expression of p16 protein in 49 cases of trophoblastic disease tissues (32 first molar specimens of hydatidiform mole, 12 specimens of invasive hydatidiform mole and uterus of choriocarcinoma specimens, and 5 specimens of normal uterus) And CyclinD1 for detection. Results The expression of p16 and CyclinD1 were all positive and all negative in early pregnancy villus. The expression of p16 in hydatidiform mole and trophoblastic tumor which did not malignant hydatidiform mole and later malignant tumor showed a decreasing trend, and the expression of CyclinD1 was on the rise. The positive rates of p16 and CyclinD1 were significantly different between non-malignant hydatidiform mole group and invasive hydatidiform mole group (P <0.05), but not between malignant hydatidiform mole group and malignant hydatidiform mole group There was no significant difference between hydatidiform mole and invasive hydatidiform mole and between invasive hydatidiform mole and choriocarcinoma (P> 0.05). Conclusion The loss of p16 expression and overexpression of CyclinD1 may play an important role in the malignant transformation of trophoblast and the occurrence of invasive mole. Detection of hydatidiform mole for the first time in patients with p16 and CyclinD1 expression may be important in determining the prognosis of hydatidiform mole