输卵管妊娠患者外周血清人绒毛膜促性腺激素与局部病变组织Ki-67表达及滋养细胞浸润深度的研究  

Study on the relationship of serum HCG levels and serum KI-67 expression with the depth of trophoblast invasion in tubal pregnancy

作　　者：张红霞[1] 李江春[1] 曾倩[1] 崔潇华[1] 孙敬之[1] 赵新然[1] 王彦敏[1] 郭洪英[1] 

机构地区：[1]河北省沧州中西医结合医院妇科,061000

出　　处：《中国综合临床》2012年第2期216-219,共4页Clinical Medicine of China

摘　　要：目的将细胞增殖抗原Ki-67做为细胞增殖活性指标来探讨滋养细胞活性及输卵管患者血人绒毛膜促性腺激素（β-hCG）与滋养细胞浸润深度的关系。方法将108例手术治疗的输卵管妊娠患者所取术中切除的输卵管标本，进行光镜检查，根据滋养细胞浸润深度分为3组，I组为滋养细胞浸润输卵管黏膜层，Ⅱ组为滋养细胞浸润肌层，Ⅲ组为滋养细胞浸润浆膜层。采用sP法检测各组标本中Ki-67的表达及术前2h内采静脉血检测β-hCG。并对B—hCG与病变组织中Ki-67的表达及滋养细胞浸润的深度进行分析。结果I组的平均血β-hCG值为（1416．64±859．94）U／L，细胞增殖抗原Ki-67的阳性表达率为21．95％，11组平均血β-hCG值为（3380．33±2392．36）U／L，细胞增殖抗原Ki-67阳性表达率为53．66％，Ⅲ组血清β-hCG值最高，平均（6999．33±4949．90）U／L，细胞增殖抗原Ki-67的阳性表达率为86．46％。Ki-67阳性表达I组与Ⅱ组、Ⅱ组与Ⅲ组、I组与Ⅲ组比较差异均有统计学意义（X2值分别为3．94、4．07、4．35，P均〈0．05）；3组患者血β-hCG值比较差异有统计学意义（F=9．914，P〈0．01）；Ki-67的阳性表达与患者血清β-hCG水平具有相关性，两者呈正相关（r=0．678，P〈0．05）。结论血清B—hCG水平越高，提示滋养细胞Ki-67阳性表达率越高，滋养细胞浸润输卵管壁亦越深。Objective To explore the relationship of depth of trophoblastie invasion with trophoblast cell activity and serum β-hCG according to the expression of proliferation antigen Ki-67 which viewed as an indicator of cell proliferation activity. Methods Fallopian tube specimens collected from 108 patients who underwent operation treatment for fallopian tubal pregnancy in our hospital were investigated by light microscopic examination. They were divided into three groups according to the depth of trophoblastic infiltration： I group （stage） ： trophoblastie invasion of tubal mucosa, II group （stage） ： trophoblastic invasion of the muscularis, m group（stage） ： trophoblast invasion of serosa layer （muscularis penetration）. The expression of Ki-67 was detected by SP method and blood β-hCG was detected within 2 hours of preoperative. The level of β-hCG, the expression of Ki-67 and the depth of trophoblast invasion were analyzed. Results Mean level of serum β- hCG in Group I , II and III were （1416. 64 ±859.94）U/L,（3380. 33 ±2392. 36 ）U/L and （6999.33 ±4949.90）U/ L respectively. Positive expression rate of cell proliferation antigen Ki-67 in Group I , II and m were 21.95% , 53.66% and 6.40% respectively. There were significant difference on the expression of Ki-67 between group I and group II , group II and III group, group I and group III（ X2 = 3.94,4. 07,4. 35, respectively,P 〈 0.05 ）. The serum β-hCG level also displayed statistics difference in the three groups （F = 9. 914, P 〈 0. 01 ）. The positive expression of Ki-67 and serum β-hCG level were positively correlated with each other （ r = 0. 678, P 〈 0.05 ） . Conclusion The high level of the serum β-hCG indicates high expression of Ki-67 and deeper trophoblast invasion of tubal wall.

关 键 词：KI-67 输卵管妊娠 滋养细胞浸润深度 血人绒毛膜促性腺激素 

分 类 号：R714.22[医药卫生—妇产科学]