增殖标志物（Ki-67、增殖细胞核抗原和银染核仁组织区）及p53肿瘤蛋白在妊娠滋养细胞疾病中的表达。

Expressions of proliferation markers (Ki-67, proliferating cell nuclear antigen, and silver-staining nucleolar organizer regions) and of p53 tumor protein in gestational trophoblastic disease.

作者信息

Kale A, Söylemez F, Ensari A

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Ankara University, Turkey.

出版信息

Am J Obstet Gynecol. 2001 Mar;184(4):567-74. doi: 10.1067/mob.2001.111243.

DOI:10.1067/mob.2001.111243

PMID:11262454

Abstract

OBJECTIVE

This study was undertaken to determine whether the expressions of 3 proliferation markers (Ki-67, proliferating cell nuclear antigen, and silver-staining nucleolar organizer regions) and of p53 tumor protein could differentiate spontaneous abortions from gestational trophoblastic diseases and also discriminate among gestational trophoblastic disease subgroups.

STUDY DESIGN

Twenty-two partial hydatidiform moles, 17 complete hydatidiform moles, 6 invasive hydatidiform moles, and 20 nonhydropic spontaneous abortions (control group) were evaluated by means of immunohistochemical techniques with antibodies to Ki-67, proliferating cell nuclear antigen, and p53. One-step silver staining was used to detect silver-staining nucleolar organizer regions.

RESULTS

The expressions of Ki-67, proliferating cell nuclear antigen, silver-staining nucleolar organizer regions, and p53 were significantly higher in the gestational trophoblastic disease group than in the control group. The results of linear discriminant analysis showed that silver-staining nucleolar organizer region count had the highest sensitivity and specificity (93.3% and 100%, respectively) for distinguishing gestational trophoblastic disease from spontaneous abortion. Sensitivity and specificity for discriminating gestational trophoblastic disease from spontaneous abortion increased to 100% when all four markers were used together. Proliferating cell nuclear antigen was found to be the best discriminating variable for differentiating among gestational trophoblastic disease subgroups.

CONCLUSION

Our findings suggest that expressions of Ki-67, proliferating cell nuclear antigen, silver-staining nucleolar organizer regions, and p53 may aid in the diagnosis of gestational trophoblastic diseases. These fairly rapid, simple, and economic techniques could serve as a useful adjunct to conventional methods in the diagnosis of gestational trophoblastic diseases.

摘要

目的

本研究旨在确定3种增殖标志物（Ki-67、增殖细胞核抗原和银染核仁组织区）及p53肿瘤蛋白的表达是否能区分自然流产与妊娠滋养细胞疾病，以及能否鉴别妊娠滋养细胞疾病的不同亚组。

研究设计

采用免疫组织化学技术，用抗Ki-67、增殖细胞核抗原和p53的抗体对22例部分性葡萄胎、17例完全性葡萄胎、6例侵蚀性葡萄胎和20例非水肿性自然流产（对照组）进行评估。采用一步银染法检测银染核仁组织区。

结果

妊娠滋养细胞疾病组中Ki-67、增殖细胞核抗原、银染核仁组织区和p53的表达显著高于对照组。线性判别分析结果显示，银染核仁组织区计数在区分妊娠滋养细胞疾病与自然流产方面具有最高的敏感性和特异性（分别为93.3%和100%）。当联合使用所有4种标志物时，区分妊娠滋养细胞疾病与自然流产的敏感性和特异性提高到100%。增殖细胞核抗原是区分妊娠滋养细胞疾病不同亚组的最佳判别变量。