Yang Shao-min, You Jiang-feng, Zhang Xiao-wei, Zheng Jie, Liao Song-lin
Department of Pathology, Peking University Health Science Center, Beijing 100191, China.
Zhonghua Bing Li Xue Za Zhi. 2009 Sep;38(9):580-4.
To study the value of combined use of paternally imprinted gene product p57(KIP2) immunohistochemistry and flow cytometry in the differential diagnosis of placental hydropic diseases.
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, p57(KIP2) immunohistochemical staining (EnVision method) and flow cytometry DNA ploidy analysis. The p57(KIP2) immunohistochemical staining and DNA ploidy results were compared with the genetic results.
In CHM, p57(KIP2) 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 p57(KIP2) -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 p57(KIP2) immunohistochemistry and flow cytometry.
p57(KIP2) immunohistochemical negativity is a reliable index for the diagnosis of CHM. Combined flow cytometry DNA ploidy and p57(KIP2) immunohistochemistry are useful in the pathological differentiation of CHM, PHM and hydropic abortions.
探讨父源印记基因产物p57(KIP2)免疫组化与流式细胞术联合应用在胎盘水肿性疾病鉴别诊断中的价值。
收集32例具有DNA多态性信息的水肿性胎盘病例,以基因检测结果作为完全性葡萄胎(CHM)、部分性葡萄胎(PHM)或水肿性流产诊断的依据。所有病例均进行组织学检查、p57(KIP2)免疫组化染色(EnVision法)及流式细胞术DNA倍体分析。将p57(KIP2)免疫组化染色及DNA倍体结果与基因检测结果进行比较。
CHM中,p57(KIP2)阴性率为95.2%(20/21),而11例非CHM(7例PHM和4例水肿性流产)均为阳性(11/11)。在11例p57(KIP2)阳性病例中,流式细胞术检测显示7例为三倍体、4例为二倍体,基因分析证实分别为PHM和水肿性流产。总体而言,p57(KIP2)免疫组化与流式细胞术联合应用对96.9%(31/32)的水肿性胎盘病例做出了正确诊断。
p57(KIP2)免疫组化阴性是诊断CHM的可靠指标。流式细胞术DNA倍体分析与p57(KIP2)免疫组化联合应用有助于CHM、PHM及水肿性流产的病理鉴别诊断。