Zhao Jun, Xiang Yang, Wan Xi-run, Feng Feng-zhi, Cui Quan-cai, Yang Xiu-yu
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Fu Chan Ke Za Zhi. 2010 Jan;45(1):35-40.
To distinguish choriocarcinoma from gestational or non-gestational choriocarcinoma and also identify the causative pregnancy of gestational choriocarcinoma by the genetic origin through molecular genetic analysis.
Twelve patients with choriocarcinoma, who had experienced surgery prior to chemotherapy were enrolled in this study. All 12 cases were diagnosed pathologically as choriocarcinoma. Peripheral venous blood samples and formalin-fixed paraffin-embedded blocks of choriocarcinoma tissue microdissected from haematoxylin and eosin-stained sections of tissue by microdissection method were available from the patient and (or) her husband. DNA was then prepared from the couples' blood samples and choriocarcinoma tissue by using standard techniques. PCR amplification and fluorescent microsatellite genotyping were performed by using DNA from the couples and captured choriocarcinoma tissues. The genetic contributions to the choriocarcinoma tissue were determined by comparing the fragments of genes from the choriocarcinoma tissue to those from blood samples of the couples.
The primary lesion was ovary in 7 cases, but only 4 of them had the maternal contribution, indicating a non-gestational origin; the other three were gestational choriocarcinoma. The primary lesion was uterus in 5 cases, which were all gestational choriocarcinoma confirmed by genetic analyses. The causative pregnancies of the 8 cases with gestational choriocarcinoma were identified as androgenetic complete hydatidiform mole (AnCHM) in six cases and normal pregnancies in two cases, respectively.
Microsatellite polymorphism analysis is a molecular approach for distinguishing the non-gestational choriocarcinoma from the gestational one, and also be used to identify the causative pregnancy of gestational choriocarcinoma.
通过分子遗传学分析,从妊娠性或非妊娠性绒毛膜癌中鉴别出绒毛膜癌,并根据遗传起源确定妊娠性绒毛膜癌的致病妊娠。
本研究纳入12例在化疗前接受过手术的绒毛膜癌患者。所有12例均经病理诊断为绒毛膜癌。患者及其丈夫可提供外周静脉血样本以及通过显微切割法从苏木精和伊红染色的组织切片中显微切割得到的绒毛膜癌组织的福尔马林固定石蜡包埋块。然后使用标准技术从夫妻双方的血液样本和绒毛膜癌组织中提取DNA。利用夫妻双方和捕获的绒毛膜癌组织的DNA进行PCR扩增和荧光微卫星基因分型。通过比较绒毛膜癌组织中的基因片段与夫妻双方血液样本中的基因片段,确定对绒毛膜癌组织的遗传贡献。
7例原发性病变位于卵巢,但其中仅4例有母系遗传成分,表明为非妊娠起源;另外3例为妊娠性绒毛膜癌。5例原发性病变位于子宫,经基因分析均为妊娠性绒毛膜癌。8例妊娠性绒毛膜癌的致病妊娠分别被确定为6例为完全性雄激素化葡萄胎(AnCHM)和2例为正常妊娠。
微卫星多态性分析是一种从妊娠性绒毛膜癌中鉴别出非妊娠性绒毛膜癌的分子方法,也可用于确定妊娠性绒毛膜癌的致病妊娠。