Expression And Significance Of PLGF,TGF-beta1 And CD44v6 In Serum With Gestational Trophoblastic Disease

Objective: The expression levels and dynamic changes of PLGF,TGF-?1 and CD44v6 in serum of normal pregnant women,patients with hydatidiform mole before and after uterine curettage and patients with gestational trophoblastic tumor before and after treatment were detected.The expression differences of PLGF,TGF-?1 and CD44v6 in serum of the three groups were analyzed,and the expression levels of the three factors in hydatidiform mole and gestational trophoblastic tumor and their correlation with the change of treatment time were also analyzed to explore the role of PLGF,TGF-?1 and CD44v6 in the development of hydatidiform mole,and to provide reference for the early diagnosis,condition evaluation and prognosis of gestational trophoblastic tumor.Methods: A total of 256 cases of hydatidiform mole were collected from January2011 to March 2019 in the Affiliated Hospital of Yan'an University,Analysis of the relationship between high risk factors and malignant transformation rate.30 patients with hydatidiform mole were randomly selected from October 2016 to March 2019 as hydatidiform mole group,All patients were followed up for 1 year,and 23 patients with gestational trophoblastic tumor were collected as GTN group.The venous blood of hydatidiform mole and gestational trophoblastic tumor patients before treatment,one day after treatment,one week after treatment,and two weeks after treatment were collected respectively.Meanwhile,the elbow venous blood of 30 women of normal pregnancy was taken as control Group,All serum specimens were from the remainder of the laboratory after hCG or biochemical assay.The concentrations of PLGF,TGF-?1 and CD44v6 in serum of all patients were detected by enzyme-linked immunosorbent assay,and the expression level of hCG was detected by chemiluminescence.After sorting out the experimental results,SPSS 22.0 was used for statistical analysis.Results:1.Patients with high risk factors of hydatidiform mole than those without high risk factors,the malignant transformation rate were significantly increased.2.The concentrations of PLGF in the serum of hydatidiform mole before uterine curettage((66.97±20.24)pg/ml)and in the serum of GTN before treatment((70.71±19.33)pg/ml)were higher than those of normal pregnant women((44.13±16.65)pg/ml),the differences were statistically significant(P <0.05).3.The concentrations of TGF-?1 in the serum of hydatidiform mole before uterine curettage((177.03±41.45)ng/ml)and in the serum before GTN treatment((185.22±39.10)ng/ml)was higher than those of normal pregnant women((120.68±37.33)ng/ml),the differences were statistically significant(P <0.05).4.The concentrations of CD44v6 in the serum of hydatidiform mole before uterine curettage((96.44±30.59)ng/ml)and in the serum before GTN treatment((107.85±22.09)ng/ml)were higher than those of normal pregnant women((68.35±28.02)ng/ml),the differences were statistically significant(P < 0.05).5.The concentrations of PLGF,TGF-?1 and CD44v6 in serum of patients with hydatidiform mole and GTN before treatment,after treatment,one week after treatment,and two weeks after treatment were measured,and the differences were statistically significant(P <0.05).6.In the serum of patients with hydatidiform mole,the expression of PLGF and TGF-?1 was positively correlated(r = 0.797,P = 0.000),the expression of PLGF and CD44v6 was positively correlated(r = 0.496,P = 0.000),the expression of TGF-?1 and CD44v6 was positively correlated(r = 0.497,P = 0.000);In the serum of patients with GTN,the expression of PLGF and TGF-?1 was positively correlated(r = 0.761,P =0.000),the expression of PLGF and CD44v6 was positively correlated(r = 0.554,P =0.000)There was a positive correlation between TGF-?1 and CD44v6 expression(r =0.331,P = 0.001).7.The predictive value of PLGF,TGF-?1 and CD44v6 for GTN by plotting ROC curve: when PlGF predicts GTN,the area under the curve was 0.803,PlGF was takes as58.555 pg/ml,it has the most diagnostic value,the sensitivity was 63%,the specificity was 86.7%;when TGF-?1 predicts GTN,the area under the curve was 0.784,TGF-?1was takes as 136.35 ng/ml,the sensitivity was 75% and the specificity was 70%;The area under the curve was 0.808 when CD44v6 was used to predict GTN.,the highest diagnostic value was obtained when the CD44v6 was 77.245 ng/ml,and the sensitivity was 84.8% and the specificity was 70%.Conclusion:1.There is a close relationship between GTN and the increased expression of PLGF,TGF-?1 and CD44v6,which can provide some basis for exploring the etiology.2.In hydatidiform mole group and GTN group,the expressions of PLGF and TGF-?1,PLGF and CD44v6,TGF-?1and CD44v6 were all positively correlated.The increased expression of PLGF,TGF-?1 and CD44v6 were related to the increased invasiveness of trophoblast,It may be related to the early events of malignant transformation of hydatidiform mole.3.When PlGF> 58.555 pg/ml,TGF-?1> 136.35 ng/ml,CD44v6>77.245 ng/ml,it has certain diagnostic value for GTN.It can be combined with serum of hCG to provide reference value for clinical diagnosis and prognosis of GTN.