Ki-67、p63、bcl-2蛋白在葡萄胎妊娠与水肿性流产中的诊断价值  

The values of Ki-67、p63 and bcl-2 in diagnosing hydatidiform moles and hydropic abortions

作　　者：李烨 贺峻祎[2] 祁明美 张友忠[1] 郝春燕[2] 崔保霞[1] Li Ye;He Junyi;Qi Mingmei(Department of Obstetrics and Gynecology,Qilu Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250012;Department of Pathology,Qilu Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250012;Department of Pathology,People's Hospital of Juxian,Juxian 276522)

机构地区：[1]山东大学齐鲁医院妇产科,济南250012 [2]山东大学齐鲁医院病理科,济南250012 [3]莒县人民医院病理科,莒县276522

出　　处：《现代妇产科进展》2021年第1期28-32,共5页Progress in Obstetrics and Gynecology

基　　金：山东省重点研发计划(No:2017CXGC1210)。

摘　　要：目的:研究Bcl-2、p63和Ki-67蛋白在鉴别完全性葡萄胎(CHM)、部分性葡萄胎(PHM)、水肿性流产(HA)中的应用价值。方法:收集山东大学齐鲁医院病理科2012年1月至2018年6月的妊娠早期葡萄胎(HM)与水肿性流产样本共139例。对以上病例样本重新阅片,同时结合p57免疫组化染色,筛选出CHM 55例,PHM 29例,HA 40例。对筛选出的样本行Bcl-2、p63、Ki-67免疫组化染色。结果:Ki-67用于鉴别HA与PHM的敏感度、特异性、阳性预测值(PPV)、阴性预测值(NPV)分别为82.5%、72.4%、80.5%和75.0%;p63用于鉴别HA与PHM的敏感度、特异性、PPV、NPV分别为95.0%、79.3%、86.4%和92.0%;p63联合Ki-67用于鉴别HA与PHM的敏感度、特异性、PPV、NPV分别为95.0%、79.3%、86.4%和92.0%。p63联合Ki-67用于鉴别HA与PHM的受试者工作特征(ROC)曲线下面积(0.934)显著高于p63(0.898),差异有统计学意义(P<0.05)。结论:Ki-67与p63用于鉴别PHM与HA具有一定的应用价值,联合使用Ki-67与p63鉴别PHM与HA比单独使用两者的准确性更高。Objective:To explore the values of bcl-2,p63 and Ki-67 proteins in the identification of complete hydatidiform mole(CHM),partial hydatidiform mole(PHM),hydropic abortion(HA).Methods:139 specimens of the first trimester gestational products,representing hydatidiform mole(HM)and HA,were retrieved from the Department of Pathology,Qilu Hospital,Cheeloo College of Medicine,Shandong University,between January 2012 and June 2018.Histological diagnosis review of all cases was performed,and combined with p57 immunohistochemical staining,55 cases of CHM,29 cases of PHM and 40 cases of HA were selected.Immunohistochemical staining was used to detect the expression of Ki-67,p63 and bcl-2 in the selected samples.Result:Ki-67 expression could distinguish HA from PHM with 82.5%sensitivity,72.4%specificity,80.5%positive predictive value(PPV),75.0%negative predictive value(NPV).p63 expression could distinguish HA from PHM with 95.0%sensitivity,79.3%specificity,86.4%PPV,92.0%NPV,and it was the same with p63 combined with Ki-67 expression.But,the area under the receiver operating characteristic(ROC)curve of p63 combined with Ki-67 for distinguishing HA from PHM(0.934)was significantly higher than that of p63(0.898),the difference was statistically significant(P<0.05).Conclusions:Ki-67 and p63 are valuable in distinguishing HA from PHM.Using Ki-67 and p63 immunohistochemistry stain together to distinguish HA from PHM is more accurate than using them alone.

关 键 词：葡萄胎 水肿性流产 BCL-2 P63 KI-67 

分 类 号：R737.33[医药卫生—肿瘤]