The Relationship Between The Expression Of β-HCG MRNA In Peripheral Blood And The Early Hematogenous Metastasis Of Gestational Trophoblastic Neoplasia

Objective：To study the expression of β-HCG mRNA in peripheral blood of thepatients with Gestational trophoblastic tumor, evaluate the relationship between theirexpression and various clinical indicators, and search for the marker with whichevaluate the early hematogenous metastasis of Gestational trophoblastic tumor.Methods： We collected the peripheral blood of28cases of Gestationaltrophoblastic tumors,15cases of hydatidiform moles,10cases of normal pregnantwomen and10cases of non-pregnant women. Mononuclear cells and trophoblastcells were extracted from the peripheral blood by density gradient centrifugationmethod,then RT-PCR was used to detect the expression of β-HCG mRNA of the fourgroups.The correlation was analyzed between the expression of β-HCG mRNA andthe clinical indicators of Gestational trophoblastic tumor and hydatidiform mole.Results：1、The expression of β-HCG mRNA in peripheral blood of ten cases ofnon-pregnant women were negative. In ten cases of normal pregnant women, threewomen showed β-HCG mRNA amplified bands.The range of β-HCG mRNA andGAPDH mRNA gray ratio was0.01-0.77.There were eight cases showed β-HCGmRNA amplified bands in15cases of Hydatidiform moles.The range of β-HCGmRNA and GAPDH mRNA gray ratio was0.02-3.56.In28cases of Gestationaltrophoblastic tumors,β-HCG mRNA amplified bands were seen in24patients.Therange of β-HCG mRNA and GAPDH mRNA gray ratio was0.04-4.56.The β-HCGmRNA expression of normal pregnancy was lower than that of Hydatidiform molesand Gestational trophoblastic tumors(P <0.05).But there was no significant differencebetween Hydatidiform moles and Gestational trophoblastic tumors in the expressionof β-HCG mRNA(P>0.05).2、There were no correlation between the expression of β-HCG mRNA inperipheral blood of patients with Gestational trophoblastic tumor and the age,previous pregnancy,interval from previous pregnancy,maximum tumor size, number of metastases， prognostic score, drug resistance, chemotherapy courses andchemotherapy efficacy (P>0.05). However, there were correlation between theexpression of β-HCG mRNA and the serum β-HCG levels before treatment, lungmetastasis and clinical stage (P<0.05). Only one case showed progression amongthose cases followed up. No case recurred. It is currently unable to assess therelationship between the expression of β-HCG mRNA and the progression orrecurrence of Gestational trophoblastic tumor.3、There were no correlation between the expression of β-HCG mRNA inperipheral blood of patients with Hydatidiform moles and the serum β-HCG levelsbefore treatment, size of the uterus, diameter of luteinized ovarian cysts, the serumβ-HCG levels after48hours of first curettage,malignant transformation (P>0.05).Conclusions：1、Mononuclear cells in peripheral blood do not express β-HCG mRNA.2、Trophoblast cells could disseminate into peripheral blood of normal pregnancy,Hydatidiform mole and Gestational trophoblastic tumor.3、β-HCG mRNA of trophoblast cell in peripheral blood may be an effectivemarker to assess the early hematogenous metastasis of Gestational trophoblastictumor.