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目的：探讨癌基因、妊娠性滋养细胞增生程度与葡萄胎恶变的关系。方法：采用针对Ｃ－Ｈａ－ｒａｓ及Ｃ－ｅｒｂＢ２基因表达产物Ｐ２１和Ｐ１８５的单克隆抗体进行免疫组织化学染色。检测８２例葡萄胎中两种基因产物的表达情况，经２年以上随访证实未发生恶变３２例为非恶变组，经手术和临床证实发生恶变５０例为恶变组，其中３５例行手术治疗。结果：恶变组Ｐ２１的表达程度低于非恶变组（Ｐ＝０．００８２）；Ｐ１８５的表达显著高于非恶变组（Ｐ＝０．００２８）。手术治疗的３５例中，恶变后两种基因产物的表达改变较恶变前更明显。两组葡萄胎中滋养细胞增生程度差异无显著性（Ｐ＝０．４１３）。不同来源的绒毛膜癌（绒癌）之间及绒癌与侵蚀性葡萄胎（侵葡）之间，Ｐ２１和Ｐ１８５的表达差异亦无显著性（Ｐ＝０．２６８，Ｐ＝０．７１９）。结论：Ｐ２１的低表达及Ｐ１８５的高表达与葡萄胎恶变有关，但与其恶性转化方向无关；滋养细胞增生程度与葡萄胎恶变亦无关。
Objective: To investigate the relationship between oncogene, gestational trophoblast hyperplasia and hydatidiform mole malignant transformation. Methods: Immunohistochemical staining was performed using monoclonal antibodies against C-Ha-ras and C-erbB2 gene expression products P21 and P185. Twenty-two cases of hydatidiform mole were examined for the expression of the two gene products. After 2 years of follow-up, 32 cases of non-malignant transformation were confirmed as non-malignant group. Fifty cases of malignant transformation were confirmed by surgery and clinical evidence. Among them, 35 cases were treated surgically. Results: The expression of P21 in malignant group was lower than that in non-malignant group (P = 0.0082). The expression of P185 was significantly higher than that in non-malignant group (P = 0.0028). In 35 cases of surgical treatment, the expression of two gene products after malignant transformation was more obvious than that before malignant transformation. There was no significant difference in trophoblast hyperplasia between the two groups (P = 0.413). There were no significant differences in the expression of P21 and P185 between choriocarcinoma (choriocarcinoma) of different origins and choriocarcinoma with invasive hydatidiform mole (P> 0.268, P = 0.719) . Conclusion: The low expression of P21 and the high expression of P185 are related to the malignant transformation of hydatidiform mole, but have no relation with the malignant transformation. The degree of trophoblast hyperplasia has no correlation with the malignancy of hydatidiform mole.