PCNA与Ki-67在葡萄胎患者宫内不同部位组织中的表达及临床意义  

Expression of PCNA and Ki-67 in hydatidiform moles in different sites of uterine cavity and their clinical values

作　　者：楼艺[1] 蔡红光[1] 史骁梁[1] 阮秀兰[1] 符孜牧[1] 

机构地区：[1]浙江省绍兴市妇幼保健院,312000

出　　处：《中国优生与遗传杂志》2005年第12期33-35,共3页Chinese Journal of Birth Health & Heredity

基　　金：2003年浙江省医药卫生重点科技项目(2003B159)

摘　　要：目的探讨PCNA和Ki-67在葡萄胎患者宫内不同部位组织中的表达对葡萄胎治疗及预后判断的意义。方法采用免疫组化S-P法检测38例葡萄胎患者宫腔中央水泡样胎块及靠宫壁蜕膜样组织中PCNA和Ki-67的表达。结果1.PCNA及Ki-67在宫中央组织阳性表达均大于靠宫壁组织。P<0.05,有明显差异。2.完全性葡萄胎PCNA及Ki-67阳性表达>部分性葡萄胎。浸润性葡萄胎PCNA及Ki-67阳性表达>完全性葡萄胎,且均为强阳性表达。3.PCNA和Ki-67在两组织中均有阳性表达,PCNA的表达更为明显,P<0.05(宫内)P<0.05(宫壁),有显著差异。结论葡萄胎宫内水泡样组织的增殖活性明显大于靠宫壁的组织,必须彻底刮净宫内组织方能预防恶变的发生。靠宫壁组织因其增殖活性较弱,可不必常规二次刮宫,以避免过度搔刮带来的过度损伤。葡萄胎的细胞增殖程度可能随疾病进展而逐渐增强,对于宫内、宫壁组织均有强阳性表达的患者要警惕其恶变的可能。PCNA与Ki-67能代表葡萄胎滋养细胞异常增生的客观指标,其检测简便、快捷、价廉,有临床价值,值得推广。Objective： We are to determine whether there is different expressions of PCNA and Ki - 67 in hydatidiform moles in different sites of uterine cavity and to assess their value. Methods ： 38 hydatidiform moles were evaluated by immunohistochemical methods with antibedies to PCNA, and Ki - 67 in this study. Moles tissues were taken both fl＇om the centre （central tissues） and near the edge （mural tissues） of uterine cavity in each patient. Results： 1. The PCNA and Ki - 67 immunoreactivity was significantly higher in the central tissues than in the mural tissues. 2. The two parameters were more easily found positive in the complete hydatidiform moles than in the partial hydatidiform moles, All the three invasive hydatidiform moles had them strongly expressed, which seemed more significant than the complete hydatidifome moles. 3. PCNA and Ki - 67 were found positive in both sites, and PCNA was expressed more significantly than Ki - 67. Conclusion： Since the proliferative activity in tissues near the edge of uterine cavity is lower, we should not take twice evacuation for each hydatidiform moles as routine therapy, The proliferate acticity of moles may be enhanced with the adrancement of the disease. If the two markers are strongly expressed in both sites, cancerizattion must be alerted. PCNA and Ki - 67 can be used as the objective indexes of the abnormal hyperplasia of trophoblasts in hydatidiform moles, and their test is simple, rapid and cheap. Since their clinical value, the test of PCNA and Ki - 67 should be popularized.

关 键 词：葡萄胎 PCNA KI-67 免疫组织化学 宫壁组织 

分 类 号：R737.33[医药卫生—肿瘤]