Nagai Yuichiro, Kamoi Seiryu, Matsuoka Toshie, Hata Akihiko, Jobo Toshiko, Ogasawara Toshitaka, Aoki Yoichi, Ohira Satoshi, Okamoto Tomomitsu, Nakamoto Tsuyoshi, Kanda Koji, Matsui Hideo
Department of Molecular Pathology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, and Department of Obstetrics and Gynecology, Chiba Hokuso Hospital, Chiba 260-8670, Japan.
Gynecol Oncol. 2007 Sep;106(3):446-52. doi: 10.1016/j.ygyno.2007.04.025. Epub 2007 Jun 4.
To identify an indicator that can predict tumor cell spread beyond the uterine corpus.
We studied clinicopathology and immunohistochemistry of 12 cases of PSTT. Two cases of epithelioid trophoblastic tumor (ETT) were included as reference cases. For immunohistochemistry, antibodies against Ki-67, p53, human chorionic gonadotropin (hCG), human placental lactogen (hPL), carcinoembryonic antigen (CEA, polyclonal antibodies; pCEA), carcinoembryonic antigen-related cellular adhesion molecule 1 (CEACAM1), and bcl-2 were used. PSTT cases were divided as confined and non-confined groups (CG and NCG, respectively). CG consisted of stage I cases with no evidence of recurrence during the follow-up, while NCG consisted of either advanced (stage II or higher) or recurrent stage I lesions.
Age, the interval from the latest pregnancy, serum hCG/hPL levels, tumor size, mitotic figures, Ki-67 labeling indices, and bcl-2 did not discriminate NCG from CG. CEACAM1 and CEA-related antigens as determined by polyclonal anti-CEA antibodies were specifically stained in PSTT cells, but they could not discriminate groups. p53 was positive in PSTT cells in NCG (6/6, 100%), while it was positive in only one case of CG (1/6, 16.7%), indicating a possible usefulness of p53 immunostaining in predicting an invasive or recurrent propensity of PSTT cells (p=0.015).
This finding also suggests the importance of p53 function in the biology of PSTT cells.
确定一种能够预测肿瘤细胞超出子宫体扩散的指标。
我们研究了12例胎盘部位滋养细胞肿瘤（PSTT）的临床病理学和免疫组织化学。纳入2例上皮样滋养细胞肿瘤（ETT）作为对照病例。免疫组织化学采用抗Ki-67、p53、人绒毛膜促性腺激素（hCG）、人胎盘催乳素（hPL）、癌胚抗原（CEA，多克隆抗体；pCEA）、癌胚抗原相关细胞黏附分子1（CEACAM1）和bcl-2的抗体。PSTT病例分为局限组和非局限组（分别为CG和NCG）。CG组包括随访期间无复发证据的I期病例，而NCG组包括晚期（II期或更高期）或复发的I期病变。
年龄、距末次妊娠的时间间隔、血清hCG/hPL水平、肿瘤大小、核分裂象、Ki-67标记指数和bcl-2均不能区分NCG组和CG组。多克隆抗CEA抗体检测的CEACAM1和CEA相关抗原在PSTT细胞中特异性染色，但不能区分两组。p53在NCG组的PSTT细胞中呈阳性（6/6，100%），而在CG组仅1例呈阳性（1/6，16.7%），表明p53免疫染色可能有助于预测PSTT细胞的侵袭或复发倾向（p=0.015）。
这一发现也提示了p53功能在PSTT细胞生物学中的重要性。
