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Histopathological analysis of early hydatidiform mole

早期葡萄胎的组织病理学分析

基本信息

批准号：
09670206
负责人：
FUKUNAGA Masaharu
金额：
$ 1.86万
依托单位：
JIKEI UNIVERSITY OF MEDICINE
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1997
资助国家：
日本
起止时间：
1997 至 1999
项目状态：
已结题

项目摘要

The widespread use of ultrasound in the diagnosis and management of intrauterine fetal death has resulted in moles being evacuated earlier than before. In order to clarify clinicopathologic features of early partial mole (PM), morphology and DNA ploidy of early (【less than or equal】12 gestational weeks) and late (>12) partial PM were studied. Eighty early and twenty late PMs (37 from 1981-90 ; 63 from 1991-98) were analyzed. Mean gestational weeks were 9.6 in early PMs and 14.8 in late PMs. Early PM was more common in 1991-98 (57/63, 90%) than in 1981-90 (23/37, 62%). Preevacuation diagnosis of hydatidiform mole was made only in four early and one late PMs. There was no significant difference in histology between early and late PMs except smaller villi in early PMs and extensive stromal fibrosis in late PMs. Seventy of 80 early PMs and 19 of 20 late PMs were tridiploid,five early PMs were aneuploid,and five early and one late PM were diploid. None of 45 patients with early PM and one of 11 with late triploid PM developed persistent gestational trophoblastic disease. Early PM is now more prevalent than it was previously. This may be a result of greater awareness of the entity of PM, its increased recognition by pathologists and the widespread use of ultrasound in the diagnosis and management of intrauterine fetal death. The diagnosis of PM should be based on pathologic examination since most PMs still escape clinical detection. DNA ploidy analysis is useful in the evaluation of problem cases. The risk of persistent disease in early PMs seems to be very low.

超声波在宫内胎儿死亡的诊断和处理中的广泛使用导致痣比以前更早被清除。为了明确早期部分性葡萄胎(PM)的临床病理特征，对早期(小于等于12孕周)和晚期(>12孕周)部分性葡萄胎的形态学和DNA倍性进行了研究。对 80 名早期和 20 名晚期 PM（1981-90 年 37 名；1991-98 年 63 名）进行了分析。早产儿的平均孕周为 9.6 周，晚产儿的平均孕周为 14.8 周。早期 PM 在 1991-98 年 (57/63, 90%) 比 1981-90 年 (23/37, 62%) 更常见。仅在 4 例早期 PM 和 1 例晚期 PM 中进行了葡萄胎的疏散前诊断。除了早期PM的绒毛较小和晚期PM的广泛间质纤维化之外，早期和晚期PM的组织学没有显着差异。 80个早期PM中的70个和20个晚期PM中的19个为三二倍体，5个早期PM为非整倍体，5个早期PM和1个晚期PM为二倍体。 45 名早期 PM 患者和 11 名晚期三倍体 PM 患者中均未出现持续性妊娠滋养细胞疾病。现在，早期 PM 比以前更加普遍。这可能是由于人们对 PM 实体的认识提高、病理学家对其认识的提高以及超声在宫内胎儿死亡的诊断和处理中的广泛使用。 PM的诊断应基于病理检查，因为大多数PM仍然无法被临床检测到。 DNA 倍体分析对于问题案例的评估很有用。早期 PM 出现持续性疾病的风险似乎非常低。