Hashimoto M
Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1987 Jul;62(4):564-72.
Complete hydatidiform moles may originate from either the fertilization of an empty egg by a haploid sperm followed by duplication (producing a monospermic, homozygous mole) or the fertilization of such an egg by 2 haploid sperm (producing a dispermic, heterozygous mole). This difference in the mechanism leading to the formation of complete moles raises the question of whether the risk of subsequent malignancy is influenced by the zygosity of the mole. In the research reported here, we compared the incidence of postmolar sequelae between patients with homozygous and heterozygous moles. Using chromosomal heteromorphism, HLA and PGM1 polymorphisms, we established the androgenetic origin of complete mole in 82 of 91 cases. Homozygosity was confirmed in 51 moles, and we found 10 heterozygous moles. Five of 10 patients with heterozygous moles developed postmolar trophoblastic disease, whereas only 2 of the 51 patients with homozygous moles had postmolar trophoblastic disease (an additional 5 patients showed signs of degenerating residual trophoblasts). A high incidence of sequelae after the expulsion of heterozygous moles suggests that the heterozygous constitution of allelic genes plays an important role in the process of malignant transformation of trophoblasts.
完全性葡萄胎可能源于单倍体精子使空卵受精后复制（产生单精子、纯合子葡萄胎），或源于两个单倍体精子使此类卵子受精（产生双精子、杂合子葡萄胎）。导致完全性葡萄胎形成的机制差异引发了一个问题，即后续恶变风险是否受葡萄胎合子性的影响。在本文报道的研究中，我们比较了纯合子和杂合子葡萄胎患者葡萄胎后后遗症的发生率。利用染色体异态性、HLA和PGM1多态性，我们确定了91例病例中82例完全性葡萄胎的父系起源。在51例葡萄胎中证实为纯合子，发现10例杂合子葡萄胎。10例杂合子葡萄胎患者中有5例发生了葡萄胎后滋养细胞疾病，而51例纯合子葡萄胎患者中只有2例发生了葡萄胎后滋养细胞疾病（另有5例患者显示有退化的残留滋养细胞迹象）。杂合子葡萄胎排出后后遗症的高发生率表明，等位基因的杂合构成在滋养细胞恶性转化过程中起重要作用。
