p57 Kip2在完全性和部分性葡萄胎与流产伴绒毛水肿中的表达及意义

常见绒毛水肿病变中p57和p53蛋白的表达及临床意义摘要】目的用免疫组化方法检测p57和p53蛋白在完全性葡萄胎、部分性葡萄胎及水肿流产胎中的诊断作用和临床意义。

方法运用免疫组化方法对12例正常绒毛组织、18例水肿流产胎、20例部分性葡萄胎、25例完全性葡萄胎中的p57和p53蛋白进行检测。

结果 p57在正常绒毛组织、水肿流产胎、部分性葡萄胎的滋养细胞的阳性比例分别为12/12、18/18、20/20，各组相比差异无统计学意义（P>0.05）。

在完全性葡萄胎中p57未见表达，与水肿流产胎及部分性葡萄胎相比差异有统计学意义（P<0.05）。

p53蛋白在正常绒毛组织中未见表达,在完全性葡萄胎表达比例为23/25、部分性葡萄胎中的表达比例为18/20、水肿流产胎中为1/18，而且水肿流产胎与完全性葡萄胎和部分性葡萄胎组间相比差异均有统计学意义（P <0.05）。

结论 p57免疫组化表达结果与葡萄胎的组织表型关系密切，对完全性葡萄胎和部分性葡萄胎及水肿流产胎有有重要的鉴别意义；p53蛋白对水肿流产胎和葡萄胎的鉴别有临床意义。

【关键词】葡萄胎免疫组织化学技术肿瘤抑制蛋白p53 周期素依赖激酶抑制剂p57【Abstract】Objective To investigate the role of p57 and p53 protein immunohistochemistry in the clinical diagnosis of hydropic abortion,partial hydatidiform mole and complete hydatidiform mole.Methods p57 and p53 protein were detected in 12 cases of normal placenta chorionic villi,18 cases of hydropic abortion,20 cases of partial hydatidiform mole and 25 cases of complete hydatidiform mole.Results The positive rates of p57 in normal placenta chorionic villi,hydropic abortion and partial hydatidiform mole were 12/12,18/18,20/20,the difference was no statistically significant in these groups（P>0.05）.The expression of p57 was negative in complete hydatidiform moles，there was a significant difference between partial and complete hydatidiform mloes（P<0.05）.No expression of p53 protein was found in normal placenta chorionic villi，the positive expression of p53 protein in complete hydatidiform mole,partial hydatidiform mole，hydropic abortion and normal placenta chorionic villi were23/25,18/20,1/18.The differences between group of hydropic abortion and groups of complete hydatidiform mole and partial hydatidiform mole were statistically significant（P<0.05）.Conclusions The Immunohistochemical expression results of p57 was closely related with tissue phenoty of hydatidiform mole. It has an important Identification diagnosis of partial hydatidiform mole from complete hydatidiform mole.p53 protein is helpful for identification of hydropicabortion and hydatidiform mole.【Key words】Hydatidiform mole Immunohistochemistry Tumor suppressor protein p53 Cyclin-dependent kinase inhibitor p57在滋养细胞疾病中，以绒毛水肿为特征的病变包括水肿流产胎、完全性葡萄胎、部分性葡萄胎三种，不同的滋养细胞病变预后不同，因此，正确区分是哪种滋养细胞病变对临床治疗和疾病的预后有指导意义。

P57免疫组化结合CEP17倍体分析在葡萄胎鉴别诊断中的作用陈永峰;薛荣;刘璇;陈云新;沈丹华【摘要】Objective To investigate the significance of P 57 immunohistochemistry and CEP 17 ploidy analysis in differential diagnosis of hydatidiform mole (HM).Methods The tissues amples, including 45 cases of complete hydatidiform mole (CHM), 25 cases of partial hydatidiform mole (PHM) and 25 cases of hydropic abortuses (HA), were collected from Urumqi Maternal and Child Health Hospital . The P57 expression and CEP17 ploidy analysis were analyzed using immunohistochemistry and fluorescence in situ hybridization FISH techniques , respectively .The significance of combining P 57 immunohistochemistry and CEP 17 ploidy analysis in the differential diagnosis of HM was further explored .ResultsP57 protein expression in PHM and HA was mainly in villous cytotrophoblast cells and stromal cells , and their rates of positive expression were 100%(25/25).But P57 expression was absent in cytotrophoblast cells and stromal cells in most CHM, and the positive expression rate was 4.4%(2/45), which was statistically different from that in PHM and HA (χ2 =61.9, both P<0.05).FISH analysis showed that CEP17 was diploid of CEP17 in 90.9% HA cases.In PHM cases, 87.0% (20/23) showed triploid of CEP17, and in CHM cases, 97.7%(42/43) showed diploid of CEP17.Statistical analysis showed that the incidence of triploid in PHM cases was significantly higher than in HA cases (χ2 =27.3, P<0.05) andCHM cases (χ2 =49.6, P<0.05).Conclusion The combined analysis of P 57 immunohistochemistry and CEP 17 ploidy plays an important role in the differential diagnosis of CHM , PHM and HA.%目的：探讨P57免疫组化结合CEP17倍体分析在葡萄胎鉴别诊断中的意义。

p57、CD34和Ki-67在胎盘绒毛水肿性病变中的表达及意义李富亮;刘春英;王云;王健;庄振娟【摘要】目的观察p57、CD34、Ki-67在完全性葡萄胎(CHM)、部分性葡萄胎(PHM)和水肿性流产胎(HA)组织中的表达,探讨其在胎盘绒毛病变诊断及鉴别诊断中的作用.方法收集2003年1月至2013年12月安丘市人民医院保存的CHM组织45例、PHM组织40例、HA组织28例及正常妊娠胎盘组织22例,采用免疫组织化学法检测胎盘绒毛组织中p57、CD34、Ki-67的表达.结果 CHM、PHM、HA及正常妊娠组织中p57阳性表达率分别为2.22％ (3/45)、85.00％ (34/40)、89.29％(25/28)、95.45％(21/22),CHM组织中p57阳性表达率显著低于PHM、HA及正常妊娠组织(x2=59.908、57.055、58.238,P＜0.01),PHM、HA及正常妊娠组织中p57阳性表达率比较差异均无统计学意义(x2=0.022、0.681、0.074,P＞0.05).CD34在CHM、PHM、HA及正常妊娠组织中的表达分别为10.27±3.00、11.13 ±2.58、35.57±2.36、35.55±2.22,CHM、PHM组织中CD34表达显著低于HA及正常妊娠组织(t=37.89、37.86、39.79、37.40,P＜0.01),HA与正常妊娠组织中CD34表达比较差异无统计学意义(t=1.485,P＞0.05),CHM与PHM组织中CD34表达比较差异无统计学意义(t=1.404,P＞0.05).Ki-67在CHM、PHM、HA及正常妊娠组织中的阳性表达率分别为64.44％ (29/45)、55.00％(22/40)、14.29％ (4/28)、9.09％(2/22),CHM、PHM组织中Ki-67阳性表达率显著高于HA及正常妊娠组织(x2=18.21、12.61、17.53、11.56,P＜0.01),HA与正常妊娠组织中Ki-67阳性表达率比较差异无统计学意义(x2=0.015,P＞0.05),CHM与PHM组织中Ki-67阳性表达率比较差异无统计学意义(x2=0.787,P ＞0.05).结论 p57有助于鉴别CHM与其他胎盘绒毛水肿性病变,CD34和Ki-67有助于鉴别葡萄胎和HA;p57、CD34和Ki-67联合检测有助于CHM、PHM及HA 的鉴别诊断.%Objective To observe the expression of p57,CD34 and Ki-67 in complete hydatidiform mole (CHM),partial hydatidiform mole (PHM) and hydropic abortus (HA),so as to investigate the role of the expression in the diagnosis and differential diagnosis of edematous lesions of placental villi.Methods A total of 45 cases of CHM tissue,40 cases of PHM tissue,28 cases of HA tissue and 22 cases of normal pregnancy tissue were collected from January 2003 to December 2013 in Anqiu People's Hospital.The expression of p57,CD34 and Ki-67 in placental villi were detected by immunohistochemistry.Results The positive expression rate of p57 in CHM,PHM,HA and normal pregnancy tissues was 2.22％ (3/45),85.00％(34/40),89.29％ (25/28) and 95.45 ％ (21/22),respectively;the positive expression rate of p57 in CHM tissues was significantly lower than that in PHM,HA and normal pregnancy tissues (x2 =59.908,57.055,58.238;P ＜0.01);there was no significant difference in the positive expression rate of p57 in PHM,HA and normal pregnancy tissues (x2 =0.022,0.681,0.074;P ＞0.05).The expression of CD34 in CHM,PHM,HA and normal pregnancy tissues was 10.27 ± 3.00,11.13 ±2.58,35.57 ± 2.36 and 35.55 ± 2.22 respectively;the expression of CD34 in CHM and PHM tissues was significantly lower than that in HA and normal pregnancy tissues (t=37.89,37.86,39.79,37.40;P ＜ 0.01).There was no significant difference in the expression of CD34 between HA and normal pregnancy tissues (t=1.485,P ＞ 0.05),and there was no significant difference in the expression of CD34 between CHM and PHM tissues (t =1.404,P ＞ 0.05).The positiveexpression rate of Ki-67 in CHM,PHM,HA and normal pregnancy tissues was 64.44％ (29/45),55.00％ (22/40),14.29％ (4/28) and 9.09％ (2/22) respectively;the positive expression rate of Ki-67 in CHM and PHM tissues was significantly higher than that in HA and normal pregnancy tissues (x2 =18.21,12.61,17.53,11.56;P ＜ 0.01);there was no significant difference in the positive expression rate of Ki-67 between HA and normal pregnant tissues (x2 =0.015,P ＞ 0.05),and there was no significant difference in the positive expression rate of Ki-67 between CHM and PHM tissues (x2=0.787,P ＞ 0.05).Conclusion p57 helps to identify CHM and other edematous lesions of placental villi,CD34 and Ki-67 help to identify hydatidiform mole and bined detection of p57,CD34 and Ki-67 is helpful for differential diagnosis of CHM,PHM and HA.【期刊名称】《新乡医学院学报》【年(卷),期】2018(035)001【总页数】4页(P35-38)【关键词】p57;CD34;Ki-67;完全性葡萄胎;部分性葡萄胎;水肿性流产胎【作者】李富亮;刘春英;王云;王健;庄振娟【作者单位】安丘市人民医院病理科,山东安丘262100;安丘市人民医院病理科,山东安丘262100;安丘市人民医院病理科,山东安丘262100;安丘市人民医院病理科,山东安丘262100;安丘市人民医院病理科,山东安丘262100【正文语种】中文【中图分类】R714.24完全性葡萄胎(complete hydatidiform mole，CHM)和部分性葡萄胎(partial hydatidiform mole，PHM)的遗传起源、疾病进展和预后均有很大不同，CHM发生恶变的概率为15%～20%，而PHM恶变的概率仅为4%～6%[1]。