120例葡萄胎染色体分析及其临床意义  

Chromosomal Analysis of 120 Cases of Hydatidiform Mole and Its Clinical Significance

作　　者：余世瑢[1] 涂灵[2] 栾树清[1] 郭玉萍[1] 付兴生[2] 汤翔群[2] 

机构地区：[1]江西省妇幼保健院遗传室,江西南昌330006 [2]江西省妇幼保健院肿瘤科,江西南昌330006

出　　处：《江西医学院学报》2001年第1期57-59,共3页Acta Academiae Medicinae Jiangxi

摘　　要：目的：探讨葡萄胎染色体分析的临床意义。方法：对120例葡萄胎患者清宫取出的标本，采用直接法制备染色体。并结合病理及临床随诊资料（随诊至少1年），对葡萄胎染色体进行了分析。结果：110例完全性葡萄胎（CHM），染色体全部为二倍体，有24例恶变（恶变率为21.82%）。10例部分性葡萄胎（PHM），染色体全部为三倍体，无1例恶变。在恶性葡萄胎中，异二倍体出现率为87.50%(21/24)，明显高于良性葡萄胎36.05%（31/86）（P＜0.01）。并发现恶性葡萄胎中异二倍体占分裂相总数40%以上，为33.33%（8/24），也明显高于良性葡萄胎的3.48%（3/86）（P＜0.01）。对异二倍体占40%以上11份病例的随诊结果：有8例恶性葡萄胎接受化疗，7例痊愈，1例死亡。3例良性葡萄胎接受预防性化疗后无1例恶变。结论：CHM比PHM更具恶变倾向，染色体是区分它们的方法之一。葡萄胎异倍体出现的频率与恶变有一定的相关性。Objective:To explore the clinical significance of chromosomal analysis of hydatidiform mole.Methods: Chromosomes of hydatidiform mole were prepared from curettage tissues by direct method and analsyed by,combination with pathology and clinical follow-up results (followed up at least for one year).Results:Among them 110 cases were of complete hydatidifom mole (CHM, all of which were diploid) and 10 cases of partial hydatidiform mole (PHM, all of which were triploid).Among the CHM,24 cases had malignant change (21.82%),but no malignant change was found among the PHM.The incidence of aneuploid in invasive mole was 87.50%(21/24),which was significantly higher than that in noninvasive mole (31/86,36.05%, P ＜0.01).It was also found that with aneuploid over 40% of the total mitotic figures accounted for 33.33%(8/24) in invasive moles,significantly higher than that in noninvasive moles (3/86,3.485%, P ＜0.01).The follow-up 11 cases with aneuploid over 40% of the total mitotic figures was as follows:8 cases of invasive mole having chemotherapy (7 cured,1 death); 3 cases of noninvasive mole having prophylactic chemotherapy without malignant change.This study shows that CHM has a stronger tendency to malignant change than PHM does and chromosomes serve to distinguish CHM from PHM.The frequency of appearance of aneuploid is correlated with malignancy.

关 键 词：葡萄胎 染色体分析 异倍体 恶变 临床分类 

分 类 号：R737.33[医药卫生—肿瘤]