Cheville J C, Robinson R, Benda J A
Department of Pathology, University of Iowa College of Medicine, Iowa City, USA.
Pediatr Pathol Lab Med. 1996 Jan-Feb;16(1):41-50.
The separation of complete from partial hydatidiform mole and of partial mole from placentas with hydropic change on gross and microscopic evaluation can be difficult, and ploidy provides important diagnostic information. We applied an immunohistochemical marker of proliferation, Ki-67 (MIB-1), to 10 complete moles, 11 partial moles, and 8 placentas with hydropic change to determine whether growth fraction differs in these three placentas and can aid in diagnosis. Ploidy was confirmed using flow cytometry and fluorescence in situ hybridization with probes to chromosomes 7 and 2. The Ki-67-determined growth fractions (number of positive cells/total number of cells) for villous stromal cells, cytotrophoblast, and proliferating trophoblast were evaluated separately by counting 200 cells of each population. Growth fraction on stroma did not differ among the three entities. Mean percent growth fraction for cytotrophoblast was 13.3% for hydropic change, 14.6% in partial moles and 38.7% in complete moles (P = .004 hydropic change to complete moles, P = .003 partial moles to complete moles). There was no significant difference between hydropic change and partial mole. Mean percent growth fraction for proliferating trophoblast was 38.5% in hydropic change, 25.9% in partial moles, and 67.1% in complete moles (P = .08 hydropic change to complete moles, P = .004 partial moles to complete moles). Again, no significant difference was identified between hydropic change and partial moles. Ploidy analysis using fluorescence in situ hybridization and flow cytometry confirmed diploidy in hydropic change and complete moles and triploidy in partial moles. Ki-67 may be useful in separating complete moles from partial moles but not partial moles from hydropic change.
通过大体和显微镜评估来区分完全性葡萄胎与部分性葡萄胎，以及区分部分性葡萄胎与有水肿改变的胎盘可能存在困难，而倍性提供了重要的诊断信息。我们对10例完全性葡萄胎、11例部分性葡萄胎和8例有水肿改变的胎盘应用增殖免疫组化标志物Ki-67（MIB-1），以确定这三种胎盘的生长分数是否不同以及是否有助于诊断。使用流式细胞术以及用针对7号和2号染色体的探针进行荧光原位杂交来确认倍性。通过对每个群体的200个细胞进行计数，分别评估绒毛间质细胞、细胞滋养层和增殖滋养层的Ki-67测定生长分数（阳性细胞数/细胞总数）。三种实体的间质生长分数没有差异。细胞滋养层的平均生长分数百分比在有水肿改变的胎盘中为13.3%，在部分性葡萄胎中为14.6%，在完全性葡萄胎中为38.7%（有水肿改变与完全性葡萄胎相比P = 0.004，部分性葡萄胎与完全性葡萄胎相比P = 0.003）。有水肿改变的胎盘与部分性葡萄胎之间没有显著差异。增殖滋养层的平均生长分数百分比在有水肿改变的胎盘中为38.5%，在部分性葡萄胎中为25.9%，在完全性葡萄胎中为67.1%（有水肿改变与完全性葡萄胎相比P = 0.08，部分性葡萄胎与完全性葡萄胎相比P = 0.004）。同样，有水肿改变的胎盘与部分性葡萄胎之间未发现显著差异。使用荧光原位杂交和流式细胞术进行的倍性分析确认有水肿改变的胎盘和完全性葡萄胎为二倍体，部分性葡萄胎为三倍体。Ki-67可能有助于区分完全性葡萄胎与部分性葡萄胎，但不能区分部分性葡萄胎与有水肿改变的胎盘。
