葡萄胎恶变相关因素的探讨及基质金属蛋白酶-9在妊娠滋养细胞疾病中表达的临床意义  

Correlative factors of the hydatidiform mole deterioration and clinical significance of matrix metalioproteinase 9 in gestational trophoblastic disease

作　　者：丁丽[1] 王霞[1] 孙丽霞[1] 

机构地区：[1]山东省日照市人民医院妇瘤科,276800

出　　处：《中国医师进修杂志》2010年第12期4-5,共2页Chinese Journal of Postgraduates of Medicine

摘　　要：目的通过测定基质金属蛋白酶（MMP）-9在不同类型滋养细胞疾病中的表达，探讨其预测葡萄胎恶变和转移的可能性；并对葡萄胎恶变相关因素进行分析，以提高对葡萄胎预后的判断。方法应用链霉菌抗生物素蛋白．过氧化物酶免疫组织化学方法对30例正常早孕（〈12周）绒毛组织、32例部分性葡萄胎、93例完全性葡萄胎、30例侵蚀性葡萄胎、5例绒毛膜癌组织中MMP-9进行检测。分析7例发生恶变的葡萄胎患者的发病年龄、子宫大小、卵巢黄素囊肿、血β-人绒毛膜促性腺激素（hCG）等因素。结果MMP-9在正常早孕绒毛组织、部分性葡萄胎、完全性葡萄胎、侵蚀性葡萄胎、绒毛膜癌组织中均有表达，但随着滋养细胞疾病恶性程度的增加，其表达强度显著升高（x^2=23．49，P〈0．05）。结论MMP-9与正常早孕滋养细胞的侵袭过程有关，MMP-9在滋养细胞疾病组织中表达的强度，与滋养细胞恶性程度的强度有关，对临床早期预测葡萄胎的恶变及预防性化疗有一定的参考意义。葡萄胎恶变还与患者发病年龄、β-hCG水平、子宫大小、卵巢黄素囊肿等因素有关。Objective To discuss the possibility of prognosing the hydatidiform mole deterioration and metastasis by detecting the expression of matrix metalloproteinase 9 （MMP-9） in different type of trophoblastic disease,and analyze the correlative factors of the hydatidiform mole deterioration,so as to improve the criterion of hydatidiform mole prognosis. Methods The expression of MMP-9 in 30 cases of normal human （less than 12 weeks） cytotrophoblast cells; 32 cases of partial hydatidiform mole, 93 cases of complete hydatidiform mole, 30 cases of invasive mole and 5 cases of choriocarcinoma were detected hy immunohistochemieal streptavidin-peroxidase. The factors as the age of onset, uterine size, luteinizing cyst, β-human chorionic gonadotropin hCG of 7 eases of the hydatidiform mole deterioration were analyzed. Results The expression of MMP-9 was detected in all types of trophoblastic cells, with the development of the malignant transformation the stainning was markedly increased in the invasion of the normal human cytotrophoblast cells （ x^2 = 23.49,P 〈 0.05）. Conclusion The difference of MMP-9 express in gestational trophoblasts is helpful to predict the hydatidiform mole deterioration and metastasis, the hydatidiform mole deterioration correlates with the age of onset, β -hCG, uterine size, luteinizing cyst.

关 键 词：葡萄胎 基质金属蛋白酶9 妊娠滋养细胞肿瘤 恶变 

分 类 号：R737.33[医药卫生—肿瘤]