Klein M, Graf A H, Hütter W, Hacker G W, Beck A, Staudach A, Kiss H, Egarter C, Husslein P
Department of Obstetrics & Gynecology, Hanusch-Krankenhaus, Vienna, Austria.
Hum Reprod. 1995 Sep;10(9):2441-4. doi: 10.1093/oxfordjournals.humrep.a136315.
Clinical observations have shown that tubal pregnancies develop individually different biological activities such as different growth rates, levels of beta human chorionic gonadotrophin (beta-HCG), or rates of tubal wall destruction. In the present study, we evaluated the proliferative activity of ectopic cytotrophoblastic tissue using immunocytochemistry with antibodies to Ki-67 (clone MIB-1). The rates of proliferation obtained were related to the maternal serum beta-HCG values. Reference data were obtained from placentas of intact intrauterine pregnancies (group I, n = 14). The proliferative activity of this tissue was compared to that of cytotrophoblastic tissue of tubal pregnancies (group II, n = 27). Ki-67-immunostained as well as non-stained cytotrophoblastic nuclei of the villi and the trophoblastic columns were counted separately, and results were expressed as percentage of positive cells. Serum beta-HCG values were determined twice, 48 h and immediately before operation. The cytotrophoblastic cells of intact intrauterine pregnancies (group I) showed uniform and high proliferative activities (80% on average in villi, 84% on average in columns). The average Ki-67 proliferation rate was significantly lower (P < 0.001) in trophoblastic tissue of tubal pregnancies (group II; 42% on average in villi, 61% on average in columns). Within the group of tubal pregnancies, higher intragroup differences were observed. The number of Ki-67-labelled cells was independent of the absolute preoperative serum beta-HCG values in both groups, yet they were clearly related to the relative increase of beta-HCG in maternal serum. At higher proliferation rates, there was a significant, growing increase of beta-HCG values (P < 0.01). We have found immunohistochemical evidence to support the previous clinical speculations that tubal pregnancies develop more heterogeneously and more slowly than intact intrauterine pregnancies. The development of the beta-HCG concentrations may be taken as an indirect parameter, reflecting proliferative activity of the trophoblast.
临床观察表明，输卵管妊娠具有个体差异的生物学活性，如不同的生长速度、β-人绒毛膜促性腺激素（β-HCG）水平或输卵管壁破坏率。在本研究中，我们使用抗Ki-67（克隆MIB-1）抗体的免疫细胞化学方法评估异位细胞滋养层组织的增殖活性。获得的增殖率与母体血清β-HCG值相关。参考数据来自完整宫内妊娠的胎盘（I组，n = 14）。将该组织的增殖活性与输卵管妊娠的细胞滋养层组织（II组，n = 27）进行比较。分别对绒毛和滋养层柱中Ki-67免疫染色以及未染色的细胞滋养层细胞核进行计数，结果以阳性细胞百分比表示。术前48小时和手术前即刻两次测定血清β-HCG值。完整宫内妊娠（I组）的细胞滋养层细胞显示出均匀且高的增殖活性（绒毛平均为80%，柱平均为84%）。输卵管妊娠的滋养层组织（II组）中平均Ki-67增殖率显著较低（P < 0.001；绒毛平均为42%，柱平均为61%）。在输卵管妊娠组内，观察到更高的组内差异。两组中Ki-67标记细胞的数量均与术前血清β-HCG绝对值无关，但它们与母体血清中β-HCG的相对增加明显相关。在较高的增殖率下，β-HCG值有显著的、不断增加的升高（P < 0.01）。我们发现免疫组化证据支持先前的临床推测，即输卵管妊娠比完整宫内妊娠发展得更具异质性且更缓慢。β-HCG浓度的变化可作为反映滋养层增殖活性的间接参数。
