Exploring The Effect Of GLP16/GLP22 Combined With P57 Protein Detection In The Diagnosis Of Hydatidiform Moles

Objective:To explore the application of GLP16/GLP22 probe combined with P57 protein detection in the diagnosis of complete hydatidiform mole(CHM)and partial hydatidiform mole(PHM).Clinical data and methods:A total of 62 patients with hydatidiform mole treated in Cangzhou people’s Hospital from March 2018 to January 2020 were collected.All the patients were pregnant and aborted,aged from 18 to 55 years old.Finally,58 patients who met the inclusion criteria,exclusion criteria and removed criteria were included in the study.The patients were classified into the group by using the gold standard short tandem repeat(STR)diagnosis method of hydatidiform mole(HM).Through the double-blind method,the cases were randomly numbered for a new round of diagnosis.firstly,the pathological sections of the patients were diagnosed by 4 experienced pathologists in pathomorphology.combined with the results of immunohistochemical detection of P57 protein,the conclusions were diagnosed by pathological experts and the results were recorded.After the elution phase,the HE section and the immunohistochemical section of P57 were removed again,and the results were combined with the ploidy results of fluorescence in situ hybridization(FISH)probe(GLP16/GLP22).The pathological diagnosis experts still adopted the double-blind method to read the film.Pathomorphology combined with immunohistochemical detection of P57 protein and GLP16/GLP22 probe detection were used in this study as a new combined diagnosis,and the new combined diagnostic methods mentioned in this paper are all this method.Experimental results:The gold standard short tandem repeat(STR)method was used to diagnose the patients who met the criteria for enrollment.There were 24 cases of complete hydatidiform mole(CHM)and 34 cases of partial hydatidiform mole(PHM).2 cases could not get the results because of sample contamination.One patient was unable to put forward the corresponding DNA for sequencing diagnosis because of improper operation,and the other case was not suitable to extract the corresponding DNA concentration for many times.Failed to run out of the corresponding map for accurate diagnosis,the remaining 58 people were tested after excluding the cases without results,and statistical analysis was carried out.A new round of combined diagnostic method was used to find complete hydatidiform mole(CHM)in 26 cases and partial hydatidiform mole(PHM)in 32 cases.The sensitivity and specificity of pathomorphology combined with immunohistochemical P57 protein in the diagnosis of HM and the new combined diagnostic method for diagnosis of HM were compared with those of gold standard short tandem repeat(STR).The sensitivity and specificity of pathomorphology combined with immunohistochemical P57 in the diagnosis of CHM and PHM were calculated.Finally,the sensitivity,specificity,Youden index,diagnostic coincidence rate,Kappa coefficient,positive likelihood ratio(LR+),negative likelihood ratio(LR-)and diagnostic dominance ratio(DOR)of the new combined diagnostic method were calculated to evaluate the diagnostic value of the new combined diagnostic test.The ROC curve of the subject’s working characteristic curve was drawn,and the diagnostic cutoff value of the supporting index GLP16/GLP22 probe in the new joint diagnostic test was selected according to the trend of ROC curve.Result:1.The pathomorphology combined with the expression of P57 in the diagnosis of HM was compared with that of the gold standard STR,and the Kappa value was 0.579(p < 0.05).The sensitivity was 79.1%,and the sensitivity 95%CI was between 0.572 and 0.920.The specificity is 79.4%,and the 95%CI of specificity is between 0.615 and 0.906.2.The comparison between the new joint diagnosis and the gold standard STR diagnosis test Kappa is 0.789 p < 0.05,statistical analysis shows that the sensitivity of the joint diagnosis method is 91.0%,the sensitivity 95%CI is 0.715-0.985,the specificity is 88.2%,the specificity95%CI is 0.716-0.961,the Youden index is 79.2%,and the diagnosis coincidence rate is 89.7%.The Kappa coefficient of this joint diagnostic test is 0.79.The value of Kappa coefficient is between-1 and 1,and the higher the value is,the higher the diagnostic value is.The positive likelihood ratio(LR+)was 7.71,the negative likelihood ratio(LR-)was 0.102,and the diagnostic odds ratio((DOR))was about 75.The greater the value,the higher the diagnostic value.The comprehensive analysis of the value of the new combined diagnostic test shows that the new combined diagnosis has higher clinical application value,higher sensitivity and specificity,and higher coincidence with the gold standard.The sensitivity and specificity of the new combined diagnosis and pathomorphology combined with immunohistochemical P57 expression classification are higher,and the diagnostic value is also higher.3.ROC curve analysis shows that in the new joint diagnostic test,the diagnostic value of GLP16/GLP22 probe is the highest when the diagnostic cutoff value of GLP16/GLP22 probe is 0 < N < 20% of the total cells.ConclusionIn the new joint diagnosis method,the diagnostic critical value of the supportive index GLP16/GLP22 probe in each high power lens visual field is3 signals,which accounts for 0 < N < 20% of the total number of cells.When the diagnosis is compared with the gold standard(STR)typing diagnosis,the sensitivity,specificity and coincidence rate are higher.The new combined diagnosis method has clinical value in the diagnosis of hydatidiform mole.