The Expression And Clinical Significance Of Maspin，p53and C-erbB-2in Gestational Trophoblastic Disease

Objects: To analyze the expressions and correlation of maspin，p53and c-erbB-2ingestational trophoblastic disease and their role in the development of hydatidiform mole，andtheir relationship with malignant high risk factors，so as to provide a theoretical basis topredict the hydatidiform mole malignant transformation.Methods: The expression of maspin，p53and c-erbB-2were detected in24cases of normalearly pregnancy，88cases of hydatidiform moles(39progressed to gestational trophoblastictumors) and11cases of gestational trophoblastic tumors(including8cases of invasivehydatidiform moles and3cases of chorionic carcinomas) with the method ofimunohistochemistry (PV-9000).Results:1. The expression of maspin was significantly lower in hydatidiform mole without and withmaliganant transformation and gestational trophoblastic tumors than that in normal earlypregnancy (P=0．016，P<0．001，P<0．001)．The expression of maspin was significantlylower in gestational trophoblastic tumors than that in hydatidiform mole without maligananttransformation(P=0．001)．The expression of maspin in hydatidiform mole with maligananttransformation was of great difference compared with that in the mole without maligananttransformation(P=0.006)．2. The expression of p53was significantly higher in hydatidiform mole without and withmaliganant transformation and gestational trophoblastic tumors than that in normal earlypregnancy (P=0．031，P<0．001，P<0．001)．The expression of p53was significantly higherin gestational trophoblastic tumors than that in hydatidiform mole without maligananttransformation (P=0．016)．The expression of p53in hydatidiform mole with maligananttransformation was of great difference compared with that in the mole without maligananttransformation (P=0.009)．3. In hydatidiform mole with maliganant transformation and gestational trophoblastictumors the expression of c-erbB-2was significantly higher than that in normal earlypregnancy (P=0．009，P=0．027)．The expression of c-erbB-2was significantly higher ingestational trophoblastic tumors than that in hydatidiform mole without maliganant transformation (P=0．048)．The expression of c-erbB-2in hydatidiform mole with maligananttransformation was of great difference compared with that in the mole without maligananttransformation (P=0.04)． There had no significantly difference between normal earlypregnancy and no malignant moles group (P>0．05)，between maliganant moles andgestational trophoblastic tumors group(P>0．05)．4. In moles with malignant high risk factors(such as HCG>100000U/L，uterus volume>gestation weeks， ovary lmein cyst>6cm)，the expression of maspin was lower than thosewithout risk factors groups(P<0.001, P <0.001，P=0.006)，while the expression of p53wassignificantly higher than that without malignant high risk factors(P=0．006,p=0.023,p=0.012).The expression of maspin and p53showed no obvious differencebetween age groups(P>0．05)．The expression of c-erbB-2in hydatidiform mole with riskfactors that uterus volume> gestation weeks was higher than in those without riskfactors(P=0．024)．The expression of c-erbB-2had no significantly difference between othergroups with and without malignant high risk factors.5. The relation is inversely between the expression of maspin and p53，c-erbB-2inhydatidiform mole(r=-0．240,r=-0．270, P=0.024, P=0.011)．Conclusion：1． Maspin expression shows a downward trend in normal early pregnancy, hydatidiformmole and gestational trophoblastic tumor，while p53, c-erbB-2show a rising trend. Theexpression of maspin and p53,c-erbB-2in hydatidiform mole were negatively correlated. It issuggested that aberrant expression of maspin and p53,c-erbB-2may contribute totrophoblastic cells invasion，penetration and metastasis，and can be used as reference index ofmalignant change hydatidiform mole forecast.2. In gestational trophoblastic disease with at least one clinical risk factors, the united ofmaspin negative expression or p53expression，shows great value to the prediction ofmalignant transformation of hydatidiform mole.