【摘要】：目的： 研究妊娠滋養(yǎng)細(xì)胞腫瘤患者外周血β-HCG mRNA表達(dá)情況，評(píng)價(jià)其表達(dá)與不同臨床指標(biāo)的關(guān)系，，尋找評(píng)估妊娠滋養(yǎng)細(xì)胞腫瘤早期血行轉(zhuǎn)移的標(biāo)志物。 方法： 收集28例妊娠滋養(yǎng)細(xì)胞腫瘤、15例葡萄胎、10例正常妊娠婦女和10例非妊娠婦女外周血。運(yùn)用外周血密度梯度離心法提取單個(gè)核細(xì)胞和滋養(yǎng)細(xì)胞后采用RT-PCR方法檢測(cè)四者β-HCG mRNA表達(dá)水平，并與妊娠滋養(yǎng)細(xì)胞腫瘤及葡萄胎的臨床指標(biāo)做相關(guān)分析。 結(jié)果： 1、10例非妊娠婦女外周血β-HCG mRNA表達(dá)均陰性。10例正常妊娠婦女外周血中3例見β-HCG mRNA擴(kuò)增條帶，β-HCG mRNA和GAPDH mRNA的灰度比值范圍為0.01-0.77。15例葡萄胎患者外周血中8例見β-HCG mRNA擴(kuò)增條帶，β-HCG mRNA和GAPDH mRNA的灰度比值范圍為0.02-3.56。28例妊娠滋養(yǎng)細(xì)胞腫瘤患者外周血中24例見β-HCG mRNA擴(kuò)增條帶，β-HCG mRNA和GAPDH mRNA的灰度比值范圍為0.04-4.56。正常妊娠婦女β-HCG mRNA表達(dá)水平低于葡萄胎、妊娠滋養(yǎng)細(xì)胞腫瘤患者（P0.05)，但葡萄胎與妊娠滋養(yǎng)細(xì)胞腫瘤患者β-HCG mRNA表達(dá)水平差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05)。 2、妊娠滋養(yǎng)細(xì)胞腫瘤患者外周血β-HCG mRNA表達(dá)與年齡、前次妊娠、距前次妊娠時(shí)間、最大腫瘤大小、轉(zhuǎn)移灶數(shù)目、預(yù)后評(píng)分、耐藥、化療療程及化療療效無(wú)關(guān)（P0.05)，與治療前血β-HCG水平、肺轉(zhuǎn)移及臨床分期有關(guān)（P0.05)。隨訪病例中只有1例進(jìn)展，無(wú)復(fù)發(fā)病例。目前無(wú)法評(píng)估外周血β-HCGmRNA與妊娠滋養(yǎng)細(xì)胞腫瘤進(jìn)展及復(fù)發(fā)的關(guān)系。 3、葡萄胎患者外周血β-HCG mRNA表達(dá)與治療前血β-HCG水平、子宮大小、卵巢黃素囊腫直徑、第一次清宮后48小時(shí)血β-HCG水平及有無(wú)惡變均無(wú)關(guān)（P0.05)。 結(jié)論： 1、外周血中單個(gè)核細(xì)胞不表達(dá)β-HCG mRNA。 2、正常妊娠、葡萄胎及妊娠滋養(yǎng)細(xì)胞腫瘤均可有滋養(yǎng)細(xì)胞進(jìn)入外周血循環(huán)。 3、外周血滋養(yǎng)細(xì)胞β-HCG mRNA可能成為評(píng)估妊娠滋養(yǎng)細(xì)胞腫瘤早期血行轉(zhuǎn)移的有效標(biāo)志物。
[Abstract]:Aim: to study the expression of 尾-HCG mRNA in peripheral blood of patients with gestational trophoblastic tumor (GTT), evaluate the relationship between the expression of 尾-TNF and different clinical parameters, and find out the markers for evaluating the early hematogenous metastasis of gestational trophoblastic tumor (GTT). Methods: peripheral blood samples were collected from 28 cases of gestational trophoblastic tumors, 15 cases of hydatidiform mole, 10 cases of normal pregnant women and 10 cases of non-pregnant women. Peripheral blood density gradient centrifugation was used to extract mononuclear cells and trophoblasts and then the expression of 尾-HCG mRNA was detected by RT-PCR method. The correlation between 尾-HCG mRNA expression and clinical indexes of gestational trophoblastic tumor and hydatidiform mole was analyzed. Results: 1. The expression of 尾-HCG mRNA in peripheral blood of 10 non-pregnant women was negative, and 尾-HCG mRNA amplification bands were found in 3 of 10 normal pregnant women. The gray scale ratio of 尾-HCG mRNA and GAPDH mRNA was 0.01? 0.77.15 cases of hydatidiform mole, 8 of them showed 尾-HCG mRNA amplification strip. The gray scale ratio of 尾-HCG mRNA and GAPDH mRNA in peripheral blood of 24 patients with gestational trophoblastic tumor was 0.02 ~ 3.56.28, 尾-HCG mRNA amplification band was found in 24 patients, and the gray scale ratio of 尾-HCG mRNA and GAPDH mRNA was 0.04 ~ 4.56. There was no significant difference between 尾-HCG mRNA and GAPDH mRNA in the peripheral blood of patients with gestational trophoblastic tumor. The expression level of 尾-HCG mRNA in normal pregnant women was lower than that in hydatidiform mole, but there was no significant difference in 尾-HCG mRNA expression between hydatidiform mole and gestational trophoblastic tumor (P0.05). 2. The expression of 尾-HCG mRNA in peripheral blood of patients with gestational trophoblastic tumor was not related to age, previous pregnancy, time to previous pregnancy, maximum tumor size, number of metastatic foci, prognosis score, drug resistance, course of chemotherapy and therapeutic effect (P0.05). Serum 尾-HCG level, lung metastasis and clinical stage were correlated with treatment (P0.05). There was only 1 progress in the follow-up cases and no recurrence. It is not possible to evaluate the relationship between 尾-HCGmRNA in peripheral blood and the progression and recurrence of gestational trophoblastic tumors. 3. The expression of 尾-HCG mRNA in peripheral blood of hydatidiform mole patients was not correlated with the level of 尾-HCG, the size of uterus, the diameter of ovarian flavin cyst, the level of 尾-HCG and whether there was malignant change 48 hours after the first uterus clearance (P0.05). Conclusion: 1. There is no expression of 尾-HCG mRNA. in peripheral blood mononuclear cells. In normal pregnancy, hydatidiform mole and gestational trophoblastic tumor, trophoblast cells enter the peripheral blood circulation. 3. Peripheral blood trophoblast 尾-HCG mRNA may be an effective marker for evaluating early blood metastasis of gestational trophoblastic tumor.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.33

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