葡萄胎恶变相关因素的分析研究

发布时间：2018-05-13 04:23

本文选题：葡萄胎恶变 + H19　；参考：《南昌大学》2014年硕士论文

【摘要】：目的：通过流行病学调查从病史中及诊疗过程中各项临床指标，，分析出与葡萄胎恶变相关因素，同时通过RT-PCR-RFLP技术在基因分子水平上对葡萄胎患者印迹基因H19和IGF2的表达进行分析，发现葡萄胎恶变患者与未恶变患者之间的基因表达差异，为葡萄胎患者合理治疗及预测预后提供参考依据。方法：收集30例确诊为葡萄胎患者的首次清宫葡萄胎组织，运用RT-PCR-RFLP技术在基因分子水平上分析葡萄胎患者及葡萄胎恶变患者印迹基因H19和IGF2的基因表达差异，同时通过流行病学病史和临床诊疗过程的数据调查并随访此30例患者分析发现葡萄胎恶变相关因素。结果： 1、本实验葡萄胎恶变与年龄、妊娠次数、药流史、口服避孕药史、阴道出血史、甲亢表现、不孕症治疗史、农药接触史、清宫前HCG大小、子宫大小、术后病理、滋养细胞增生程度无相关性，差异无统计学意义（P0.05)。有无自然流产史及清宫术后HCG是否呈对数下降与葡萄胎恶变具有相关性，差异有统计学意义（P＜0.05) 2、30例葡萄胎组织标本中，H19选出了8例杂合子，IGF2选出了12例杂合子，H19和IGF2都为杂合子的有3例，H19基因状态检测结果：4个葡萄胎标本为等位基因均表达，4个葡萄胎标本单等位基因表达；IGF2基因状态检测：5个葡萄胎标本为等位基因均表达，7个为单等位基因表达。其中发生恶变的葡萄胎4例，2例为纯合子，1例为H19杂合子，1例为IGF2杂合子，H19和IGF2为等位基因均表达。结论： 1、自然流产病史和清宫术后24小时HCG不呈对数下降与葡萄胎恶变有关。 2、印记基因H19和印记基因IGF2的基因表达与葡萄胎恶变无相关性。
[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.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

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