p57、p53和Ki-67蛋白在葡萄胎诊断中的价值  

Diagnostic value of p57,p53 and Ki-67 protein in hydatidiform mole

作　　者：钟萍萍[1] 顾依群[1] 孙云飞[1] 卢利娟[1] 王爱春[1] 

机构地区：[1]北京市海淀区妇幼保健院病理科,北京100080

出　　处：《诊断病理学杂志》2014年第6期391-394,共4页Chinese Journal of Diagnostic Pathology

基　　金：北京市海淀区科技项目(No:K2008058)

摘　　要：目的探讨联合应用p57、p53和Ki-67蛋白对葡萄胎的诊断价值。方法收集有完整临床资料的流产病例,包括22例完全性葡萄胎、26例部分性葡萄胎、27例水肿性流产病例,并以12例正常早期妊娠流产病例作为对照组。全部病例进行免疫组化p57、p53及Ki-67检测。结果 22例完全性葡萄胎中,20例p57为(-);所有部分性葡萄胎、水肿性流产及正常早期妊娠病例p57均为(+)。完全性葡萄胎、部分性葡萄胎、水肿性流产及正常早期妊娠p53阳性率分别为95.5%、84.6%、14.8%和0,差异显著(P<0.05);大多数完全性葡萄胎p53呈强或中等强(+),水肿性流产p53阳性率为14.8%,且仅呈弱(+)。而完全性葡萄胎、部分性葡萄胎、水肿性流产及正常早期妊娠中Ki-67阳性率分别为100%、84.6%、48.2%和91.7%,差异显著(P<0.05),阳性表达率分别为(80.9±9.2%)、(27.1±14.4%)、(21.7%±15.9%)和(46.3±22.7%),差异显著(P<0.05)。所有完全性葡萄胎Ki-67呈强(+)。结论 p57、p53和Ki-67对于诊断葡萄胎有重要价值。p57(-)且p53和Ki-67强(+)支持完全性葡萄胎;p57(+),但p53和Ki-67强(+)需要排除完全性葡萄胎可能;p57(+)且p53和Ki-67(-)提示为水肿性流产。Objective To investigate the diagnosis value of p57,p53 and Ki-67 protein in hydatidiform moles.Method 22 cases of complete hydatidiform moles,26 cases of partial hydatidiform moles and 27 cases of hydropic abortions were collected,with complete clinical data.p57,p53 and Ki-67 immunohistochemical staining were performed in all the cases and 12 cases of early pregnancy abortions were used as control group.Results The number of negative cases in p57 immunohistochemistry were 20 out of 22 of complete hydatidiform moles （CHM）.However,p57 immunohistochemistry was positive in all cases of partial hydatidiform moles （PHM）,hydropic abortions （HA） and early pregnancy abortions.The positive rate of p53 in CHMs,PHMs,HAs and early pregnancy abortions group was 95.5%,84.6%,14.8% and 0,respectively,with stastistic difference （P 〈 0.05）.Positive cases of p53 immunohistochemistry had strong or moderate intensity expression in CHMs,while only weak intensity expression in 14.81% HAs.The positive rate of Ki67 in CHMs group was 100% and the average expression rate （80.90 ± 9.21） %,in PHMs group the positive rate 84.62% and the average expression rate （27.1 ± 14.4） %,in HAs group the positive rate 48.2% and the average expression rate （21.7 ± 15.9） %,in early pregnancy abortions group the positive rate 91.67% and the average expression rate 46.25% ± 22.27 %.All cases of CHMs had strong intensity expression of Ki-67.Conclusion The combination of p57,p53 and Ki67 immunohistochemistry is important in the diagnosis of hydatidiform moles.Negative p57 immunohistochemical staining and strong expression in p53 and Ki-67 support the diagnosis of CHM; but p57 immunohistochemical positivity and p53,Ki-67 immunohistochemical strong positivity need to exclude the possible diagnosis of CHM.Positive p57 expression but negative p53 amd Ki-67 expression suggests HAs.

关 键 词：葡萄胎 P57 P53 KI-67 免疫组化 

分 类 号：R737.33[医药卫生—肿瘤]