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  本文選題：葡萄胎惡變 + H19　； 參考：《南昌大學(xué)》2014年碩士論文

【摘要】：目的： 通過流行病學(xué)調(diào)查從病史中及診療過程中各項臨床指標，，分析出與葡萄胎惡變相關(guān)因素，同時通過RT-PCR-RFLP技術(shù)在基因分子水平上對葡萄胎患者印跡基因H19和IGF2的表達進行分析，發(fā)現(xiàn)葡萄胎惡變患者與未惡變患者之間的基因表達差異，為葡萄胎患者合理治療及預(yù)測預(yù)后提供參考依據(jù)。 方法： 收集30例確診為葡萄胎患者的首次清宮葡萄胎組織，運用RT-PCR-RFLP技術(shù)在基因分子水平上分析葡萄胎患者及葡萄胎惡變患者印跡基因H19和IGF2的基因表達差異，同時通過流行病學(xué)病史和臨床診療過程的數(shù)據(jù)調(diào)查并隨訪此30例患者分析發(fā)現(xiàn)葡萄胎惡變相關(guān)因素。 結(jié)果： 1、本實驗葡萄胎惡變與年齡、妊娠次數(shù)、藥流史、口服避孕藥史、陰道出血史、甲亢表現(xiàn)、不孕癥治療史、農(nóng)藥接觸史、清宮前HCG大小、子宮大小、術(shù)后病理、滋養(yǎng)細胞增生程度無相關(guān)性，差異無統(tǒng)計學(xué)意義（P0.05)。有無自然流產(chǎn)史及清宮術(shù)后HCG是否呈對數(shù)下降與葡萄胎惡變具有相關(guān)性，差異有統(tǒng)計學(xué)意義（P＜0.05) 2、30例葡萄胎組織標本中，H19選出了8例雜合子，IGF2選出了12例雜合子，H19和IGF2都為雜合子的有3例，H19基因狀態(tài)檢測結(jié)果：4個葡萄胎標本為等位基因均表達，4個葡萄胎標本單等位基因表達；IGF2基因狀態(tài)檢測：5個葡萄胎標本為等位基因均表達，7個為單等位基因表達。其中發(fā)生惡變的葡萄胎4例，2例為純合子，1例為H19雜合子，1例為IGF2雜合子，H19和IGF2為等位基因均表達。 結(jié)論： 1、自然流產(chǎn)病史和清宮術(shù)后24小時HCG不呈對數(shù)下降與葡萄胎惡變有關(guān)。 2、印記基因H19和印記基因IGF2的基因表達與葡萄胎惡變無相關(guān)性。
[Abstract]:Objective: The factors related to the malignant transformation of hydatidiform mole were analyzed from the clinical indexes in the history and diagnosis and treatment of hydatidiform mole, and the expression of H19 and IGF2 in hydatidiform mole was analyzed by RT-PCR-RFLP technique at the gene molecular level. It was found that the difference of gene expression between patients with hydatidiform mole malignancy and those without malignancy could provide reference for rational treatment and prognosis prediction of hydatidiform mole. Methods: The tissue of hydatidiform mole was collected from 30 patients with hydatidiform mole, and the difference of H19 and IGF2 gene expression of H19 and IGF2 was analyzed at the level of gene molecule with RT-PCR-RFLP technique in patients with hydatidiform mole and malignant transformation of hydatidiform mole. At the same time, the data of epidemiological history and clinical diagnosis and treatment were investigated and 30 cases of hydatidiform mole malignancy were analyzed. Results: 1. Malignant change and age of hydatidiform mole, times of pregnancy, history of drug flow, history of oral contraceptive pill, history of vaginal bleeding, manifestation of hyperthyroidism, history of infertility treatment, history of pesticide exposure, size of HCG before uterus, size of uterus, postoperative pathology. There was no correlation between the degree of trophoblastic proliferation and the difference was not statistically significant (P 0.05). The relationship between the history of spontaneous abortion and the logarithmic decline of HCG after uterine clearance was associated with the malignant change of hydatidiform mole (P < 0.05). 2Among 30 samples of hydatidiform mole, 8 cases of heterozygote IGF2 and 12 cases of heterozygote H19 and IGF2 were selected out of 30 cases of hydatidiform mole. The results showed that 4 samples of hydatidiform mole were allelic and 4 were labeled as hydatidiform mole. The status of IGF2 gene was detected by single allele expression: alleles were all expressed in 5 samples of hydatidiform mole and 7 were expressed in single allele. Among them, 4 cases of malignant hydatidiform mole 2 cases of homozygote 1 case of H19 heterozygote and 1 case of IGF2 heterozygote H19 and IGF2 alleles were expressed. Conclusion: 1. The history of spontaneous abortion and 24 hours after uterine clearance showed no logarithmic decline of HCG, which was related to the malignant change of hydatidiform mole. 2. The gene expression of imprint gene H 19 and imprint gene IGF2 had no correlation with malignant transformation of hydatidiform mole.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.33

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本文編號：1881649