Berkowitz R S, Umpierre S A, Taylor-Emery S, Goldstein D P, Anderson D J
Cancer Metastasis Rev. 1986;5(2):109-23. doi: 10.1007/BF00046426.
The unique curability of gestational trophoblastic tumors may in part be attributable to a host immunologic response. The occurrence of rapidly progressive and fatal choriocarcinoma may be favored by histocompatibility between patients and their partners. However, histocompatibility is not a prerequisite for the development and persistence of gestational choriocarcinoma. The expression of HLA by choriocarcinoma cells in culture is enhanced following incubation with gamma-interferon and this may be of both biologic and clinical significance. Complete molar pregnancy is a complete allograft because all molar chromosomes are of paternal origin. Patients with complete mole are sensitized to paternal HLA antigen which is expressed in molar tissue. Other polymorphic antigen systems including trophoblast-leukocyte common antigens and placental-type alkaline phosphatase are also expressed in molar tissue. We have studied the immunopathology of the molar implantation site to investigate possible humoral and cellular immune responses. The relationships among normal placenta, complete mole and choriocarcinoma are not clearly understood. The pattern of expression of oncofetal antigens in these three gestational tissues may be used to assess trophoblastic differentiation. In studies to date, molar trophoblast has the same pattern of expression of oncofetal antigens as normal placental trophoblast. We will review recent advances in our understanding of the immunobiology of gestational trophoblastic disease and suggest new directions for further research.
妊娠滋养细胞肿瘤独特的可治愈性部分可能归因于宿主免疫反应。患者与其伴侣之间的组织相容性可能有利于快速进展和致命性绒毛膜癌的发生。然而，组织相容性并非妊娠绒毛膜癌发生和持续存在的先决条件。培养的绒毛膜癌细胞与γ干扰素孵育后，HLA的表达增强，这可能具有生物学和临床意义。完全性葡萄胎是一种完全同种异体移植物，因为所有葡萄胎染色体均来自父方。完全性葡萄胎患者对在葡萄胎组织中表达的父方HLA抗原致敏。包括滋养层-白细胞共同抗原和胎盘型碱性磷酸酶在内的其他多态性抗原系统也在葡萄胎组织中表达。我们研究了葡萄胎着床部位的免疫病理学，以调查可能的体液免疫和细胞免疫反应。正常胎盘、完全性葡萄胎和绒毛膜癌之间的关系尚不清楚。这三种妊娠组织中癌胚抗原的表达模式可用于评估滋养层细胞的分化。在迄今为止的研究中，葡萄胎滋养层细胞与正常胎盘滋养层细胞具有相同的癌胚抗原表达模式。我们将综述我们对妊娠滋养细胞疾病免疫生物学理解的最新进展，并提出进一步研究的新方向。
