A Study On The Expression And Significance Of CD105, VEGF And CD34in Hydatidiform Mole

ObjectiveHydatidiform mole (HM) is one of the gestational trophoblastic diseases (GTD) with the main pathological characteristics being the abnormal proliferation of trophoblastic cells, villous interstitial substance edema, and villous vessel reduction or disappearance. Depending on the presence of fetus or appendages, it can be categorized as partial hydatidiform mole (PHM) or complete hydatidiform mole (CHM). Hydropic abortus (HA) results from the degeneration of villus, as displayed under the microscope by the villous interstitial substance edema. The histologic features of hydatidiform mole and hydropic abortus are often confused, and presently there are no immunohistochemical standards that can accurately distinguish them. From the observation of the difference of expressions of CD105, VEGF and CD34in villus of normal pregnancy(NP), HA, PHM and CHM, this study analyzes the correlation and significance of these antibodies, explore the pathogeny of HM and HA, and thus identify characteristic features to differentiate these two.MethodsFrom January2009to December2011,70cases of hydatidiform moles and hydropic abortion specimens were collected after first uterus curettage in the Tianjin Central Hospital of Gynecology and Obstetrics. Among them are30cases of hydropic abortus (HA),20cases of partial hydatidiform moles (PHM), and20cases of complete hydatidiform moles (CHM). As a comparison,20cases of normal pregnancy (NP) villous were chosen in the same period of time after artificial abortion operation in our hospital. The expression of CD105, VEGF and CD34in the four groups of specimens, as well as CD34counting microvessel density(MVD), were identified using immunohistochemical SP method. These data were analyzed by statistic software SPSS, version18.0.Results1. In NP, HA, PHM and CHM groups, CD105was mostly expressed in the syncytiotrophoblast cytomembrane, and expressed less in the syncytiotrophoblast cytoplasm and endothelial cell of decidual tissue. However, CD105was not expressed in the cytotrophoblast, villous interstitial substance and villous interstitial vessel. For the NP specimens, CD105was uniformly distributed in the syncytiotrophoblast cytomembrane and circle the surface of villous. In the HA, CD105was partly reduced or disappeared. In the PHM and CHM, CD105was expressed mainly in the syncytiotrophoblast cytomembrane which was irregular, radial, and multipolar proliferation of the villus. The positive ratio of expression in the NP, HA, PHM, CHM were55.0%,36.7%,85.0%,95.0%, respectively. The expression rates of CD105in PHM were significantly higher than those in NP (P=0.023) and HA (P=0.012), the expression rates of CD105in CHM were also significantly higher than those in NP (P=0.018) and HA (P=0.011), and the differences are statistically meaningful.2. In NP, HA, PHM, and CHM groups, VEGF was mostly expressed in the villous trophoblastic cytoplasm, and expressed less in the villous interstitial substance and decidual tissue. There were no obvious difference in the expression sites in NP. HA, PHM and CHM. The positive ratio of expression in the NP, HA, PHM, CHM were50.0%,33.3%,25.0%,15.0%, respectively. The expression rates of VEGF in PHM were lower than those in NP (P=0.033) and HA (P=0.037), the expression rates of VEGF in CHM were also lower than those in NP (P=0.030) and HA (P=0.034), and the differences are statistically meaningful.3. In this study, it is found that the expression level of CD105increases, and that of VEGF decreases, from HA to PHM, and then to CHM specimens. The result of Spearman correlation test showed there was a negative correlation of expression level between CD105and VEGF in HA, PHM and CHM[r(HA)=-0.181,r(PHM)=-0.204, r(CHM)=-0.211,P<0.05].4. CD34was mostly expressed in the cytomembrane and cytoplasm of endothelial cells of villous interstitial substance and decidual tissue. There were no obvious difference in the expression sites in NP, HA. PHM and CHM. The microvessel density of CD34in PHM were lower than those in NP (P=0.037) and HA (P=0.039), the microvessel density of CD34in CHM were also lower than those in NP (P=0.031) and HA (P=0.032), and the differences are statistically meaningful. ConclusionIn this study, the immunohistochemical streptavidin-perosidase staining method was chosen to analyze the different expression levels of CD105, VEGF and CD34in NP, HA, PHM and CHM specimens. We can prove that the initiation and development of hydatidiform moles is correlated with the abnormal proliferation of trophoblastic cells, the villous interstitial substance edema, and the reduction or disappearance of villous vessels. The high expression level of CD105in PHM and CHM may suggest the enhanced invasiveness of trophoblastic cells by CD105. The negative correlation between the expression levels of CD105and VEGF in HA,PHM and CHM suggests that the lower expression level of VEGF, to a certain degree, promotes the higher expression level of CD105in trophoblastic cells, which result into the excessive proliferation of trophoblastic cells and invasion to the maternal. The reduced expression level of CD34in PHM and CHM suggests that CD34leads to angiogenesis and vascular developmental disorders, affects the water backflow in villous interstitial substance, and therefore results into a high degree of edema and the formation of water pool. The difference in the expression of these antibodies in HA. PHM and CHM can be used as indicators for the diagnosis of hydatidiform mole and hydropic abortus.