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Objective: Gestational trophoblastic diseases is a group of diseases, which come from placenta villi nourish cells. According to histological, it is divided into hydatidiform mole, invasive hydatidiform mole, choriocarcinoma and placental site trophoblastic tumor. Gestational trophoblastic diseases is one of the common diseases of gynaecology. Regional incidence difference is bigger, the incidence of North America is 0.6 ~ 1.1 case / 1000 cases of pregnancy, the incidence of Asian region is 7 ~ 10 times of North America. Hydatidiform mole is a benign diseases of gestational trophoblastic diseases,due to the hyperplasia of gestational trophoblastic and villi edema, make villi into sizes blisters,its erosion ability is small.But some hydatidiform mole have potential risk, such as local invasion and (or) distant metastasis,the incidence of local invasion and (or) the distant metastasis is about 15% and 4%. Invasive hydatidiform mole also called malignant hydatidiform mole,its characteristic is uterine local invasion or transferred to the nearby or distant organ.If invasive hydatidiform mole or choriocarcinoma can be discovered on time, be treatmented appropriate, cure rate can reach 90%.Due to the limit of current diagnosis method and the markers of gestational trophoblastic diseases, invasive hydatidiform mole or choriocarcinoma can’t be discovered on time, be treatmented appropriate, therefore, new markers and therapeutic targets have become focus of a basic researchers and clinicians.Studies have shown that the happening of the disease and development is more genes, multi-step complex process, these genes involved in many important signals adjust approach, will make extracellular impulses to the nucleus, thus participate in a series of physiological processes,such as cells’s grow, growth and differentiation, and play a very important role in the transformation of malignant cell.At present, the new gene constantly to be found, make people have further information to the happening of the disease and development from genetic and molecular level on. IMP3 gene(Insulin-like growth factor-II mRNA-binding protein 3),as a member of insulinlike growth factor II mRNA-binding proteins, is a new recognition carcinoma embryo protein,which expresses in embryonic tissues and cancers.The reasearches have showed that IMP3 genes can combine mRNA from different purpose gene to paricipate in mRNA transcription regulation and reverse transcript.It involves in the cell growth and differentiation process,IMP3 gene expresses excessively in malignant tumor tissues and is closely related to the occurrence and development of malignant tumor.In this study,we detect the expression of IMP3 gene in different outcome in patients with hydatidiform mole first the expression differences hydatidiform mole organization by immunohisto -chemistry, further discussed the action mechanisms of IMP3 genes from hydatidiform mole to invasive hydatidiform mole,in order to investigate the role of IMP3 gene in hydatidiform mole’s occurrence and the relationship between the outcome,for providing help to early diagnosis invasive hydatidiform and monitor its treatment.Methods:The sample was obtained from pathlogy of the second hospital of HeBei Medical University and Capital Medical University, July1990 - July 2010, hydatidiform mole patients first uterine curettage paraffin specimens, 200 cases of hydatidiform mole patients were divided into two groups , the patients of HCG﹥2X10~5mIU/ml hydatidiform mole have 100 cases and HCG﹤2X10~5mIU/ml hydatidiform mole have 100 cases.The age of HCG﹥2X10~5mIU/ml is 20 - 53, the average age is 32.05±0.93. The age of HCG﹤2X10~5mIU/ml is 19 - 54 , the average age is 33.66±1.01.The age of the two groups have no significant differences. Some patients are determined as invasive hydatidiform mole by follow-up bloodβ-HCG after uterine curettage.In the 100 patients of HCG﹥2X10~5mIU/ml hydatidiform mole ,have 21 cases developed into invasive hydatidiform mole.In the 100 patients of HCG﹤2X10~5mIU/ml hydatidiform mole ,have 8 cases developed into invasive hydatidiform mole. The sample was fixed use 10% formalin, paraffin embedding preservation, select the corresponding pathological, according to HE staining sections to select the corresponding paraffin tissue. This experiment use immunohistochemistry SP method ,to detect the expression of IMP3 gene in hydatidiform mole ,whose outcome is different. IMP3 protein located in cell plasma, cell plasma or in the cell nucleus with yellow or brown as positive, the stained results is measured by the product of the precent of positive stain and percentage of positive cell numbers in all congeneric cell. All the data were analyzed with SPSS13.0 system, and a p-value of less than 0.05 was considered to be statistically significant.Results:The expression of IMP3 in the hydatidiform mole.The results of Immunohistochemical suggest:IMP3 mainly located in the cytoplasm of hydatidiform mole,IMP3 gene expressed in HCG﹥2X105mIU/ml hydatidiform mole and HCG﹤2X105mIU/ml hydatidiform mole.Statistics show that the positive rate of IMP3 gene in HCG﹥2X105mIU/mlhydatidiform mole is 90%, in HCG﹤2X105mIU/ml hydatidiform mole is 78%.There is a significant difference between them(P <0.05). In HCG﹥2X105mIU/ml hydatidiform mole, later developed into invasive hydatidiform mole, the positive rate of IMP3 gene in that patients is higher. There is statistically significant differences between groups (P = 0.013 <0.05). In HCG﹤2X105mIU/ml hydatidiform mole, later developed into invasive hydatidiform mole, the positive rate of IMP3 gene in that patients is higher. There is statistically significant differences between groups(P=0.002﹤0.05).Conclutions:1 IMP3 protein as a high specificity of cytoplasm markers, it mainly expressed in nourish cells of hydatidiform mole, the expression rate is higher in the HCG﹥2X105mIU/ml hydatidiform mole organization.2 IMP3 protein is closely correlated with the transition of hydatidiform mole, which reveals that IMP3 gene may be involved in cell growth and differentiation process.May be as the marker to judge occurrence and development and prognosis of hydatidiform mole, so that early diagnosis and early treatment to invasive hydatidiform mole.
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