CAJ | 학술논문

目的研究父源性印迹基因p57KIP2蛋白表达结合DNA倍体分析对葡萄胎的辅助诊断意义.方法收集32例具有DNA多态性遗传学分析资料的胎盘绒毛水肿病例,以遗传学分析结果作为葡萄胎的诊断依据.全部病例进行常规组织学检查、p57KIP2免疫组织化学染色(EnVision法)及流式细胞术DNA倍体分析,采用双盲法与遗传学分析结果对照.结果 32例绒毛水肿病例的遗传学分析证明,21例为完全性葡萄胎(CHM),7例为部分性葡萄胎(PHM),4例为水肿性流产.CHM p57KIP2免疫组织化学表达的阴性率为95.2%(20/21).非CHM的p57KIP2免疫组织化学全部阳性(11/11).p57KIP2免疫组织化学与DNA多态性分析结果的吻合率为96.9%(31/32).流式细胞术分析发现,7例PHM均为三倍体核型;21例CHM中有14例为二倍体,7例为四倍体;4例水肿性流产均为二倍体或近二倍体.结论 p57KIP2免疫组织化学阴性是CHM的可靠标志物.p57KIP2免疫组织化学结合流式细胞倍体分析可明确区分三种胎盘绒毛水肿性病变.p57KIP2免疫组织化学阴性支持CHM,p57KIP2免疫组织化学阳性且为三倍体为PHM,p57KIP2阳性且为二倍体支持水肿性流产.
목적 연구부원성인적기인p57KIP2단백표체결합DNA배체분석대포도태적보조진단의의.방법 수집32례구유DNA다태성유전학분석자료적태반융모수종병례,이유전학분석결과작위포도태적진단의거.전부병례진행상규조직학검사、p57KIP2면역조직화학염색(EnVision법)급류식세포술DNA배체분석,채용쌍맹법여유전학분석결과대조.결과 32례융모수종병례적유전학분석증명,21례위완전성포도태(CHM),7례위부분성포도태(PHM),4례위수종성유산.CHM p57KIP2면역조직화학표체적음성솔위95.2%(20/21).비CHM적p57KIP2면역조직화학전부양성(11/11).p57KIP2면역조직화학여DNA다태성분석결과적문합솔위96.9%(31/32).류식세포술분석발현,7례PHM균위삼배체핵형;21례CHM중유14례위이배체,7례위사배체;4례수종성유산균위이배체혹근이배체.결론 p57KIP2면역조직화학음성시CHM적가고표지물.p57KIP2면역조직화학결합류식세포배체분석가명학구분삼충태반융모수종성병변.p57KIP2면역조직화학음성지지CHM,p57KIP2면역조직화학양성차위삼배체위PHM,p57KIP2양성차위이배체지지수종성유산.
Objective To study the value of combined use of paternally imprinted gene product p57KIP2 immunohistochemistry and flow cytometry in the differential diagnosis of placental hydropic diseases.Methods A total of 32 cases of hydropic placenta with DNA polymorphism information were collected,and the genetic results were used as basis for the diagnosis of complete hydatidiform moles(CHM),partial hydatidiform moles(PHM)or hydropic abortions.All cases were examined by histology,p57KIP2 immunohistochemical staining(En Vision method)and flow cytometry DNA ploidy analysis.The p57 immunohistochemical staining and DNA ploidy results were compared with the genetic results.Results In CHM,p57KIP2 negative rates were 95.2%(20/21),whereas all the 11 cases of non-CHM(7 cases PHM and 4 cases hydropic abortions)were positive(11/11).In 11 p57KIP2-positive cases,7 cases with triploidy and 4 cases with diploidy by flow cytometry were proven to be PHM and hydropic abortions by genetic analysis,respectively.Overall,96.9%(31/32)cases of hydropic placentas were correctly diagnosed by combined use of p57KIP2 immunohistochemistry and flow cytometry.Conclusions p57KIP2 immunohistochemical negativity is a reliable index for the diagnosis of CHM.Combined flow cytometry DNA ploidy and p57KIP2 immunohistochemistry are useful in the pathological differentiation of CHM,PHM and hydropic abortions.