Department of Pathology, Peking University People's Hospital, Beijing, China.
Wien Klin Wochenschr. 2012 Mar;124(5-6):184-7. doi: 10.1007/s00508-011-0119-4. Epub 2012 Jan 9.
The aim of the present study was to investigate the expression of Ki-67, P53 and P63 in hydropic abortion and partial mole and to explore possible role of these three parameters in distinguishing partial mole from hydropic.
The hydropic abortion (n = 13) and partial mole (n = 23) were retrieved from the files of 2002 to 2010 at the Department of Pathology, Peking University People's Hospital and Department of Pathology, Haidian Maternal and Child Health Hospita1. All cases had typical histological features and complete clinical information. All pathologic diagnoses were reviewed by two gynaecologic pathologists and had no conflict. All cases showed P57 negative, which can exclude the diagnosis of CHM. An immunochemical study of the expressions of Ki-67, P53 and P63 was performed.
Microscopically, the pathologic characteristics of a HA include villous oedema with minimal to no cistern formation and mild trophoblastic hyperplasia. In contrast, the pathologic features of PHM were characterized by focal trophoblastic hyperplasia and a variable degree of hydropic swelling with central cistern formation. The Ki-67 expression was observed in the nuclear of cytotrophoblastic cell and intermediate trophoblasts population within placental tissue. The Ki-67 expression in HA is less than that in PHM. The p53 expression was observed in the nuclear of cytotrophoblastic cell and intermediate trophoblasts population within placental tissue. There was a significant difference between HA and PHM. Positive staining for P63 was localized in the nuclei of cytotrophoblastic cell population. No significant difference was observed in positive rate of p63 expression between HA and PHM.
The high Ki-67 labeling index and over-expression of p53, detected by immunohistochemistry, could serve as useful adjuncts to conventional methods of diagnosis in distinguishing PHM from HA. Due to, however, the limited samples, it needs to expand the number of the cases to verify this conclusion.
本研究旨在探讨 Ki-67、P53 和 P63 在葡萄胎和部分性葡萄胎中的表达，并探讨这三个参数在鉴别部分性葡萄胎与葡萄胎水肿中的可能作用。
从北京大学人民医院病理科和海淀区妇幼保健院病理科 2002 年至 2010 年的档案中检索到葡萄胎水肿流产（n=13）和部分性葡萄胎（n=23）。所有病例均具有典型的组织学特征和完整的临床资料。所有病理诊断均由两名妇科病理学家进行复查，无分歧。所有病例均表现为 P57 阴性，可排除 CHM 的诊断。进行 Ki-67、P53 和 P63 表达的免疫化学研究。
镜下，HA 的病理特征包括绒毛水肿，很少有或没有小囊形成，滋养层轻度增生。相比之下，PHM 的病理特征是滋养层局灶性增生，并有不同程度的水肿，中央小囊形成。Ki-67 表达位于胎盘组织中滋养细胞和中间滋养细胞的核内。HA 中的 Ki-67 表达少于 PHM。p53 表达位于胎盘组织中滋养细胞和中间滋养细胞的核内。HA 和 PHM 之间存在显著差异。p63 的阳性染色定位于滋养细胞的核内。HA 和 PHM 之间 p63 表达的阳性率无显著差异。
免疫组织化学检测到高 Ki-67 标记指数和 p53 过表达，可作为鉴别 PHM 与 HA 的常规方法的有用辅助手段。然而，由于样本有限，需要扩大病例数来验证这一结论。
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