Pregnancy Cell Proliferation Mechanism Of Chemotherapy Tumor Research And Nourishment

Gestational trophoblastic disease comprises a heterogeneous group of related lesions arising from abnormal proliferation of trophoblast of the placenta. Histologically, it is classified into hydatidiform mole, invasive mole, choriocarcinoma, placental site trophoblastic tumor (PSTT) and epithelial trophoblastic tumor (ETT). In the absence of histopathologic diagnosis, the four latter types are collectively called gestational trophoblastic neoplasia (GTN).Hydatidiform moles are usually benign and display high curability after the complete expulsion of molar tissues. However, approximately10-30%of patients with HMs develop malignant conditions known as gestational trophoblastic diseases (GTDs), which require chemotherapy for disease resolution. For a long time, the serum human chorionic gonadotropin (hCG) concentration has been used to determine the state of malignant transformation of HMs; however, hCG often takes several weeks or months to rise after uterine evacuation. Currently, there is no prognostic marker available that can determine which HMs will transform into GTDs at the time of uterine evacuation.The patients with GTNs have an excellent prognosis when treated with chemotherapy. Although some patients may require alternate chemotherapeutic regimens in order to achieve remission, almost all of them can be cured with chemotherapy. A variety of agents have been used as chemotherapy regimens for GTN; however, the optimal primary chemotherapy for GTN has not yet been unified in clinical.The study include two parts:The purpose of the fundamental research was to identify prognostic biomarkers indicating malignant transformation of hydatidiform moles (HMs). The objective of the clinical research was to evaluate the primary chemotherapeutic regimens for GTNs.The mTOR signaling pathway is one of pathways involved in many tumorigenesis and is currently under intensive investigation. mTOR plays important role in regulation various cellular functions, including cell proliferation, metabolism, growth and differentiation. mTOR related proteins are kinases belonging to the family of serine/threoninekinases, are activated by phosphorylation to exert cellular function.The expression of mTOR signaling pathway related proteins in9HM tissue samples were evaluated by immunohistochemistry and western blot.The conclusion shows that mTOR signaling pathway may play a role in the development of malignant-transformation HM. The over-expression of PTEN may serve as an early prediction for malignant transformation. Compared with spontaneous remission HM, the significantly increased expression of p-AKT and p-P70S6K in malignant transformation HM may indicate that they may play a role in the malignant transformation of HM.In present study, we investigate the efficacy and toxicity of pulsed Actinomycin D given biweekly in the primary treatment of low-risk gestational trophoblastic neoplasia. The conclusion shows that pulsed Actinomycin D given biweekly may be effective and well tolerated for low-risk GTN, it is the treatment of choice because of its greater convenience and lower cost. Furthermore, we also evaluate the efficacy and toxicity of floxuridine, actinomycin D, vincristine (FAV) regimen as primary treatment for gestational trophoblastic neoplasia (GTN), the result shows that FAV is an effective, well-tolerated regimen for patients with the low-risk GTN, and able to reduce the relapse of GTN.