p16 Cyclin D１在妊娠滋养细胞疾病组织中rn 的表达及意义

摘要

Objective To detect the significance of p16 and CyclinD1 in the tumorigenesis of trophoblastic tumors.Methods Immunohistochemical SP method was used to detect the p16 and CyclinD1 gene expression in the tissues of 49 cases of trophoblastic diseases ( the primary curretage tissues of moles 32 cases, invasive moles 12 cases and choriocarcinoma 5 cases ) and 4 cases of normal chorion of early gestation. Results The expression of p16 and CyclinD1 was respectively all positive and all negative in the chorion of early gestation. When the moles that didn′t transform to malignancy, the moles that did transform and the trophoblasfic tumors were detected,a descending tendency of p16 expression was found ,while the expression of CyclinD1 showed an ascending tendency. The positive rate of p16 expression was significantly different between the following groups: the moles transforming malignantly later and the moles that didnt transform,the moles that didnt transform and the invasive moles( P <0.05 ) ,so was the positive rate of CyclinD1 expression. It was also observed that there wasnt significant difference between the moles that transformed later and the invasive moles, the invasive moles and the choriocarcinomas when either of the genes was detected (P>0.05). Conclusions The absent expression of the cell cycle regulating gene pi6 and the excessive expression of cyclinD1 may play a key role in the malignant transformation of trophocyte and in the development of invasive moles. Detection of p16 and Cyclin D1 expression in the primary curretage tissues of moles may be of great value in assessing the prognosis of moles.%目的探讨p16、CyclinD1基因在滋养细胞肿瘤发生方面的意义。方法用免疫组化SP法，对49例滋养细胞疾病组织(葡萄胎首次清宫标本32例，侵蚀性葡萄胎及绒癌子宫标本分别为12例和5例)和4例早孕正常绒毛组织中p16和CyclinD1进行检测。结果在早孕绒毛组织中，pi6和CyclinD1表达分别为全部阳性和全部阴性。在不恶变葡萄胎、以后发生恶变的葡萄胎和滋养细胞肿瘤中p16表达呈下降趋势，CyclinD1表达呈上升趋势。p16和CyclinD1表达阳性率在不恶变葡萄胎与以后发生恶变的葡萄胎组间、在不恶变葡萄胎组与侵蚀性葡萄胎间均有显著差异(P<0.05)；而以后发生恶变的葡萄胎与侵蚀性葡萄胎间及侵蚀性葡萄胎与绒毛膜癌间无显著差异(P>0.05)。结论 p16表达缺失、CyclinD1过表达可能在滋养细胞恶性转化、侵蚀性葡萄胎发生中起重要作用。检测葡萄胎首次清官标本p16及CyclinD1表达，可能在判断葡萄胎预后方面具有重要意义。