Lorenzato M, Visseaux-Coletto B, Lallemand A, Masure M, Gaillard D
Laboratoire Pol Bouin, Chru Maison Blanche, Reims, France.
Pathol Res Pract. 1995 Dec;191(12):1179-85. doi: 10.1016/S0344-0338(11)81123-4.
In order to determine reliable histological features characterizing triploidy, the following features were examined and graded by three pathologists on 46 early abortion specimens: hydropic swelling of the villi, cisterns, villous scalloping, trophoblastic hyperplasia with syncytial vacuolization, single cytotrophoblastic cells in villous stroma, trophoblastic inclusions, microcalcifications and fibrosis. At the same time, the DNA content of the 46 specimens was quantified cytophotometrically using the CAS 200 image analyzer, in order to confirm or not the diagnosis of triploidy. Triploidy was confirmed in 45.7%, and in the triploid group, the grading of three features differed significantly from the non triploid group i.e. cisterns (p < 0.001), trophoblastic hyperplasia (p < 0.05) and trophoblastic inclusions (p < 0.05). Using these three features we were able to give a triploid score per slide which represents the sum of the grades of each of these three features. The minimum score obtained was 0, the maximum was 6. The average of these scores in the triploid group was 3.095, and 1.45 in the non triploid group (p < 0.001). This scoring method on the three significant features (cisterns, trophoblastic hyperplasia and trophoblastic inclusions) appears to be useful to classify an abortion specimen as triploid or not, and to select the specimens for which a DNA quantification may be necessary.
为了确定表征三倍体的可靠组织学特征,三名病理学家对46例早期流产标本的以下特征进行了检查和分级:绒毛水肿、池状结构、绒毛扇贝样变、伴有合体滋养细胞空泡化的滋养细胞增生、绒毛间质中的单个细胞滋养层细胞、滋养细胞包涵体、微钙化和纤维化。同时,使用CAS 200图像分析仪对46个标本的DNA含量进行细胞光度法定量,以确认或排除三倍体诊断。45.7%的标本被确诊为三倍体,在三倍体组中,三个特征的分级与非三倍体组有显著差异,即池状结构(p < 0.001)、滋养细胞增生(p < 0.05)和滋养细胞包涵体(p < 0.05)。利用这三个特征,我们能够为每张切片给出一个三倍体评分,该评分代表这三个特征各自分级的总和。获得的最低评分为0,最高评分为6。三倍体组这些评分的平均值为3.095,非三倍体组为1.45(p < 0.001)。这种基于三个显著特征(池状结构、滋养细胞增生和滋养细胞包涵体)的评分方法似乎有助于将流产标本分类为三倍体与否,并选择可能需要进行DNA定量的标本。