2.嚢胞化絨毛のゲノム研究-基礎から臨床へ(特別講演,第63回日本産科婦人科学会・学術講演会)

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In the present study, we validated the macroscopic diagnosis based on the Japan society of obstetrics and Gynecology (JSOG) classification of gestational trophoblastic diseases. A total of 297 samples of hydropic villi were classified according to DNA polymorphisms as androgenetic moles, dispermic triploids, or bi-parental diploids, clinically corresponding to complete moles, partial moles and hydropic abortion, respectively. A subset of appropriate 267 samples were included in the study. Most of the macroscopically diagnosed complete mole cases were genetically androgenetic in origin. The partial mole cases consisted of 30 androgenetic moles and 12 dispermic triploids. For the 59 cases macroscopically categorized as hydropic abortion, the genetic analysis revealed 38 androgenetic moles, 7 disprormic triploid and 14 bi-parental diploid. These result showed that a new diagnostic method was required for the management of patients with hydropic villi. We identified the TSSC imprint gene of which expression was shown in normal and partial mole villi but was silenced in complete mole villi. Immunohistochemistry using the TSSC3 antibody demonstrated its efficacy as the differential diagnostic method. We reviewed the outcome of 200 patients (178 androgenetic moles, 13 dispermic triploids and 9 biparental diploids). Twenty-eight cases (16%) with androgenetic moles developed postmolar gestasional trophoblastic disease (GTD). None of the case with dispermic triploid or bi-parental diploid developed GTD. These results implicate the requirement of the revision of JSOG classification.
2011-10-01

2.嚢胞化絨毛のゲノム研究-基礎から臨床へ(特別講演,第63回日本産科婦人科学会・学術講演会)

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