p57、ki-67联合HCG在水泡状胎块中的表达及意义

The Expression of p57 and ki-67 and Its Clinical Significance in Hydatidiform Mole

摘要: 目的：分析完全性水泡状胎块(CHM)、部分性水泡状胎块(PHM)及水肿流产胎(HA)临床病理特点，检测p57蛋白、ki-67抗原的表达在诊断和鉴别诊断中的意义。方法：应用免疫组化S-P法对46例完全性水泡状胎块，32例部分性水泡状胎块，10例绒毛水肿及10例正常绒毛(NMPs)进行p57、ki-67免疫组化检测，用统计学方法计算其表达情况与临床分型的关系。结果：1) 在CHM中，45例绒毛细胞滋养层p57阴性，1例部分细胞表达；在PHM、32例均阳性，表达强度+11例，++15例，+++6例；绒毛水肿和正常绒毛p57为阳性表达。2) 在CHM中，ki-67表达强度++11例(23.9%)，+++35例(69.1%)；PHM中ki-67均阳性，表达强度+5例(15.5%)；++24例(75.0%)，+++3例(9.5%) HA ki-67表达强度在2%~6%。3) 经统计学分析，p57表达在CHM与PHM及HA之间均存在显著性差异(P < 0.05)，而PHM与HA之间无显著性差异(P > 0.05)。ki-67在CHM、PHM及HA三者之间均存在显著性差异(P < 0.05)。作为对照的正常绒毛组织免疫组化结果显示，p57、ki-67均阳性表达。结论：p57、ki-67免疫组化结果与水泡状胎块的组织表型关系密切，对CHM、PHM和HA的鉴别诊断有重要作用。

Abstract: Objective: To analyze clinical-pathological features of complete hydatidiform moles (CHM), partial hydatidiform moles (PHM) and hydropicabortion (HA) and to study the significance of p57 and ki-67 in the diagnosis. Methods: The immunohistochemical expression of p57 and ki-67 protein was investigated using paraffin-embedded tissue sections in histologically unequivocal cases of complete mole (n = 46), partial mole (n = 32), hydropic abortion (n = 10) and normal mature pla-centas (n = 10). Results: 1) 45 cases of expression of p57 were negative; 1 case was weakly positive in the CHM. In contrast, it was strongly and continuously expressed in 32 cases of PHM and 10 of HA. 2) In CHM, expression of ki-67 was ++11 cases (23.9%), +++35 cases (69.1%); in PHM, expression of ki-67 was +5 cases (15.5%); ++24 cases (75.0%), +++3 cases (9.5%). 3) The difference of p57 expression between CHMs and PHMs, CHMs and HAs was statistically significant (P < 0.01), and the difference of ki-67 expression between PHMs and CHMs was statistically significant (P < 0.01). Conclusions: p57 and ki-67 immunostaining results correlate well with morphological features of molar pregnancies and are helpful in differential diagnosis of CHM from PHM and HA.