| ObjectiveHydatidiform mole is a gestational trophoblastic disease with trophoblast cell proliferation and varying degrees of villous interstitial edema as the main pathological features. There are two different types:complete hydatidiform moles (CHM) and partial hydatidiform moles (PHM) according to the fetus and appendages.. Hydropic abortus (HA) is the degeneration of villus, in which villus stops growing blood vessels stop growing and vanish because of fetal death, then the water absorbed by human chorionic epithelium couldn’t be transported to the fetus within blood vessels, then villus begain to swell. Both hydatidiform moles and hydropic abortus can not accurately be distinguished in general presently and no immunohistochemical indicators can tell the precise difference between them. The experiment is to investigate the relationship between CD99, MMP-2, PTEN, VEGF and gestational trophoblastic disease by detecting their expression and correlation.Methods70cases of hydatidiform moles and hydropic abortion specimens were collected in Hospital of Tianjin Central Hospital of Gynecology and Obstetrics, including20cases of complete hydatidiform moles (CHM),20cases of partial hydatidiform moles (PHM) and30cases of hydropic abortus (HA).20cases of normal placent were chosen for normal control. The expression of CD99, MMP-2, PTEN and VEGF in the four groups was detected using immunohistochemical SP method, all data analysed by statistic software SPSS, version16.0.Results:①In the NP and HA, CD99was expressed mainly in the polarity of the villus proliferation. In the HM, CD99was evenly distributed in the cytotrophoblast cells. The positive ratio of expression in the NP, HA, CHM, PHM were52.31%,49.83%,25.85%,25.40%;②MMP-2was expressed in the syncytiotrophoblast cytoplasm of NP, HA, CHM and PHM, and there were no obvious difference in the expression site. In the NP, HA, CHM, PHM, the positive ratiao of expression were30.0%,36.7%,80.0%,85.0%; ③The expression of CD99and MMP-2in HA、 CHM、 PHM were different and there was significant difference, and the expression of them were all negatively correlated in three groups[r(HA)=-0.133,r(CHM)=-0.154,r(PHM)=-0.153, P<0.05].④PTEN mainly expressed in the nucleus and parts of the cytoplasm of cytotrophoblast and syncytiotrophoblast cells. There were no obvious difference in the expression site of the four groups, the positive ratio of expression were90.0%,86.7%,40.0%and35.0%.⑤VEGF mainly expressed in the cytoplasm of trophoblast cells, villous stroma and villous vascular endothelial cells, it expressed in all the four groups, and the positive ratio of expression were40.0%,35.0%,15.0%,20.0%.⑥The expression of PTEN and VEGF in hydatidiform moles were lower in hydatidiform moles than in normal placenta and hydropic abortus, and the difference was statistically significant (P<0.05).Conclusion:In this study, CD99, MMP-2, PTEN and VEGF were detected in the four groups using immunohistochemical staining, confirmed that these four indicators played an important role in the incidence of gestational trophoblastic disease. The positive ratio of CD99was significantly decreased in HMs than in HA, which may be related to the influence of trophoblast adhesion and differentiation given by CD99, and the increased expression of MMP-2in hydatidiform moles may related to the activation owing to the reduction of CD99expression. The expression of PTEN in hydatidiform moles was significantly decreased, suggesting a correlation between the proliferation of trophoblast cells and loss of PTEN expression. VEGF expressed at a low level in hydatidiform moles, confirmed in the hydatidiform moles, the down regulation of VEGF affects angiogenesis, resulting in vascular developmental disorders. These four proteins could be used as indicators to the diagnosis and clinical treatment of gestational trophoblastic disease. |
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