Lage J M, Weinberg D S, Yavner D L, Bieber F R
Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115.
Hum Pathol. 1989 May;20(5):419-25. doi: 10.1016/0046-8177(89)90005-1.
We identified three cases of tetraploid hydatidiform moles (HM). A complete hydatidiform mole (CM) had a 92,XXXX karyotype. The two partial hydatidiform moles (PM) had karyotypes of 69,XXY/90,XXXY,-11,-13 and 92,XXYY, respectively. Study of chromosomal heteromorphisms in the 92,XXYY PM revealed two maternal and two paternal haploid sets. Flow cytometric analysis of nuclear DNA content from fresh placental tissue from the 69,XXY/90,XXXY,-11,-13 PM demonstrated distinct peaks in the triploid and tetraploid regions and an octaploid G2/M peak. Flow cytometric analysis of paraffin-embedded, fixed tissue was diagnostic of tetraploidy in the 92,XXXX CM and consistent with tetraploidy in the 92,XXYY PM. All three patients achieved spontaneous remission of elevated gonadotropin levels. These three cases of tetraploid HM do not fit into the usual patterns of diploid CM and triploid PM. We conclude that flow cytometric analysis of nuclear DNA may be used to identify polyploidy in fresh and paraffin-embedded, fixed placental tissues. Categorization of all molar placentas on the basis of ploidy presents rare opportunities to study the biology and natural history of gestational trophoblastic disease in tetraploid HM.
我们鉴定出3例四倍体葡萄胎（HM）。1例完全性葡萄胎（CM）的核型为92,XXXX。2例部分性葡萄胎（PM）的核型分别为69,XXY/90,XXXY,-11,-13和92,XXYY。对92,XXYY部分性葡萄胎的染色体异态性研究显示有两个母源单倍体组和两个父源单倍体组。对69,XXY/90,XXXY,-11,-13部分性葡萄胎新鲜胎盘组织的核DNA含量进行流式细胞术分析，在三倍体和四倍体区域显示出明显的峰，以及一个八倍体G2/M峰。对石蜡包埋的固定组织进行流式细胞术分析诊断92,XXXX完全性葡萄胎为四倍体，且与92,XXYY部分性葡萄胎的四倍体情况一致。所有3例患者的促性腺激素水平均自发恢复正常。这3例四倍体葡萄胎不符合通常的二倍体完全性葡萄胎和三倍体部分性葡萄胎模式。我们得出结论，核DNA的流式细胞术分析可用于鉴定新鲜的以及石蜡包埋的固定胎盘组织中的多倍体。基于倍性对所有葡萄胎胎盘进行分类，为研究四倍体葡萄胎中妊娠滋养细胞疾病的生物学特性和自然史提供了难得的机会。
