Clinical Manifestation Of Gestational Trophoblastic Disease And Expression Of Matrix Metallo Proteinase

Gestational trophoblastic disease (GTD) is composed of a seriesof diseases related with pregnancy. matrix metallo proteinase (MMPs)is a group of enzymes sharing many biological properties which candegrade extracellular matrix (ECM). Up till now, at least twenty-onekinds that can be discovered, and it almost can degrade allcomposition of ECM. Under physiological conditions, it participatesin the transfer of cells and reconstruction of ECM and underpathological conditions, it participates in the decomposition of extracellular matrix and advances the metastasis of tumor. The combinationof tissue inhibitor of metalloproteinases (TIMPs) and itscorresponding MMP zymogens as well as its activating form, however,can inhibit the activation of MMP and the production of inhibitiongenes which make tumors deteriorate and transfer. According to recentstudies, unbalanced adjustment of MMP-TIMP plays a decisive role inthe deterioration and transfer of tumors. The invasion and transfer oftrophoblastic tumor have such properties as invasion upon vessels andtransmission through blood at an early stage. Without timely diagnosisand treatment, this disease can be fatal. Therefore, the key to theincrease of healing rate is to widen the knowledge of GTD as well asto improve the doctors' ability to diagnose. In this experiment ofeptavidin-Peroxidase (S-P), the changing law revealed by MMP9 andTIMP-1 in ten cases of normal villimole, ten cases of hydatidiformmole (HM), ten cases of invasive mole (IM) and ten cases ofchoriocarcinoma (CC) has been studied so as to provide certain basisfor the early clinical discovery of hydatidiform mole deteriorations.The result of this experiment is as follows: MMP-9 is mainly locatedin endochylema, presented as yellow particles;meanwhile, a smallnumber of cell membranes and cell mesenchyma are colored;thedyeing of cytotrophoblast is stronger than that of syncytiotrophoblast.The positive expression of MMP-9 in normal early pregenancy bloomtissue, hydatidiform mole, invasive mole and choriocarcinoma is 40%,50%, 100% and 100% respectively, showing that Showing that withproper presentation MMP-9 expression malignant cells stainingpositive to increase their level of a few cells and stating intensityincreased. TIMP-1 is also mainly located in endochylema, anddistributed evenly in both cytotrophoblast and syncytiotrophoblast.The positive expression of TIMP-1in normal early pregenancy bloomtissuem, hydatidiform mole, invasive mole and choriocarcinoma is100%, 90%, 70% and 60% respectively. And with the increasesedlevel of vicious tumor, the degree of staining and staining cellpercentage reduction. Showing that the expression of TIMp-1 isgradually reducing. The conclusion reached by this experiment is asfollows: MMP-9 participates in the invasion upon normal earlypregnancy malignant cell and TIMP-1 makes trophoblastic cell invadein a controllable form. The test of MMP9 in hydatidiform mole clearuterus tissue is expected to become the criteria for judging thedeterioration of hydatidiform mole.Gestational trophoblastic disease (GTD) is a series of diseasesderived from gestation instead of patients themselves, with thecarrying of origin of father genes as a distinction from other tumors.The cause of this disease hasn't been discovered, so the study of thisdisease and its epidemic characteristics helps to improve ourunderstanding of the disease and raise the level of the preventionagainst it. In this thesis, the author both gathered and analyzedreferable data in the latest ten years, from January 1994 to January,2004 on one hundred and seventy-five cases of trophoblastic diseasepatients who have been in hospital. Among these cases, there are 113cases of hydatidiform mole, 20 cases of invasive mole and 30 cases ofchoriocarcinoma. 110 out of 113 cases of hydatidiform mole havebeen healed. The result of this analysis is as follows: The rate ofpregnant women over 40 years old catching various kinds ofgestational trophoblastic diseases increases sharply (p<0.01);The ageof catching hydatidiform mole, invasive mole and choriocarcinoma isalike, mainly during the child-bearing age and 69% occurs at the agebetween 20 to 30. It's more likely for those who have been pregnanttwice to develop gestational trophoblastic disease, according to whichwe can see that the rate of catching gestational trophoblastic disease isclosely related with times of pregnancy;For those 42% patients whoseblood type is A, the relative rate of danger has been increased by 1.88times and for those rural women, by 2.57 times;The most obviousclinical expression is menelipsis (147 cases, 84%), vagina bleeding(163 cases, 93% ). The rate of qualified first diagnosis is 74.3% andthe rate of misdiagnosis is 25.7%, among which 47% of misdiagnosisrises from prognostic abortion. Transfer to the lung is the mostcommon one to the gestational trophoblastic disease (14 cases), whilethere are only 2 cases of other transfer. The conclusion reached by theanalysis is as follows: 1 Though 69% of various gestationaltrophoblastic diseases are caught by patients between the age of 20 to30, it's more likely for those pregnant women over 40 yeas old todevelop this disease compared with those of other age. 2 The rate ofcatching gestational trophoblastic disease is closely related with timesof pregnancy. 3 Rural inhabitants are more likely to develop thisdisease compared with their urban counterparts. 4 For women whoseblood type is A, the relative rate of danger is higher. 5 Mainly clinicalexpression is menelipsis and vagina bleeding. What's more,misdiagnosis frequently occurs, among which those caused byprognostic abortion is the most common. 6 trophoblastic tumorfrequently appears as lung transfer and patients are younger withquickening and fierce deterioration.