p57^KIP2表达结合流式细胞术分析对葡萄胎的辅助诊断价值  

Roles of p57^KIP2 immunohistochemistry and flow cytometry in diagnosis of molar pregnancy

作　　者：杨邵敏[1] 由江峰[1] 张小为[2] 郑杰[1] 廖松林[1] 

机构地区：[1]北京大学医学部病理学系,100191 [2]北京大学第三医院妇产科

出　　处：《中华病理学杂志》2009年第9期580-584,共5页Chinese Journal of Pathology

摘　　要：目的研究父源性印迹基因p57^KIP2蛋白表达结合DNA倍体分析对葡萄胎的辅助诊断意义。方法收集32例具有DNA多态性遗传学分析资料的胎盘绒毛水肿病例，以遗传学分析结果作为葡萄胎的诊断依据。全部病例进行常规组织学检查、p57^KIP2免疫组织化学染色（En Vision法）及流式细胞术DNA倍体分析，采用双盲法与遗传学分析结果对照。结果32例绒毛水肿病例的遗传学分析证明，21例为完全性葡萄胎（CHM），7例为部分性葡萄胎（PHM），4例为水肿性流产。CHMp57^KIP2免疫组织化学表达的阴性率为95．2％（20／21）。非CHM的p57^KIP2免疫组织化学全部阳性（11／11）。p57^KIP2免疫组织化学与DNA多态性分析结果的吻合率为96．9％（31／32）。流式细胞术分析发现，7例PHM均为三倍体核型；21例CHM中有14例为二倍体，7例为四倍体；4例水肿性流产均为二倍体或近二倍体。结论p57^KIP2免疫组织化学阴性是CHM的可靠标志物。p57^KIP2免疫组织化学结合流式细胞倍体分析可明确区分三种胎盘绒毛水肿性病变。p57^KIP2免疫组织化学阴性支持CHM，p57^KIP2免疫组织化学阳性且为三倍体为PHM，p57^KIP2阳性且为二倍体支持水肿性流产。Objective To study the value of combined use of paternally imprinted gene product p57^KIP2 immunohistochemistry and flow cytometry in the differential diagnosis of placental hydropic diseases. Methods A total of 32 cases of hydropic placenta with DNA polymorphism information were collected, and the genetic results were used as basis for the diagnosis of complete hydatidiform moles （ CHM ）, partial hydatidiform moles （PHM） or hydropic abortions. All cases were examined by histology,p57^KIP2 immunohistochemical staining （EnVision method） and flow cytometry DNA ploidy analysis. The p57^KIP2 immunohistochemical staining and DNA ploidy results were compared with the genetic results. Results In CHM, p57^KIP2 negative rates were 95.2% （20/21）, whereas all the 11 cases of non-CHM （7 cases PHM and 4 cases hydropic abortions） were positive （ 11/11 ）. In 11 p57^KIP2-pOsitive cases, 7 cases with triploidy and 4 cases with diploidy by flow cytometry were proven to be PHM and hydropic abortions by genetic analysis, respectively. Overall, 96. 9% （31/32） cases of hydropic placentas were correctly diagnosed by combined use of p57^KIP2 immunohistochemistry and flow cytometry. Conclusions p57^KIP2 immunohistochemical negativity is a reliable index for the diagnosis of CHM. Combined flow cytometry DNA ploidy and p57^KIP2 mmunohistochemistry are useful in the pathological differentiation of CHM, PHM and hydropic abortions.

关 键 词：葡萄胎 基因组印迹 二倍性 多倍性 流式细胞术 

分 类 号：R686[医药卫生—骨科学]