摘要目的探讨p57和p53蛋白在水肿性流产、完全性和部分性葡萄胎鉴别诊断中的作用。方法分别收集正常绒毛、水肿性流产、部分性葡萄胎和完全性葡萄胎石蜡标本10、12、23和20例，应用免疫组织化学EnVision法检测p57和p53蛋白在这些组织中的分布及表达水平。结果p57蛋白在正常绒毛、水肿性流产及部分性葡萄胎组织中主要分布于绒毛的细胞滋养细胞及间质细胞，阳性表达比例分别为10/10、12/12和100％( 23/23)，各组间相比差异无统计学意义(P＞0.05)。在完全性葡萄胎中细胞滋养细胞及间质细胞p57表达缺失，与部分性葡萄胎相比，差异有统计学意义(P＜0.05)。p53蛋白主要表达于完全性和部分性葡萄胎的细胞滋养细胞及中间滋养细胞。在正常绒毛中p53蛋白呈阴性表达，水肿性流产中仅1例p53蛋白呈阳性表达(1/12)，部分性葡萄胎和完全性葡萄胎中p53蛋白的阳性率分别为60.9％( 14/23)和85.0％ (17/20)；p53蛋白的阳性率，部分性葡萄胎较水肿性流产明显增加，完全性葡萄胎较部分性葡萄胎也明显增加，差异均有统计学意义(均P ＜0.05)。结论p57蛋白免疫组织化学检测可辅助鉴别完全性和部分性葡萄胎，而p53蛋白的检测则有助于鉴别水肿性流产和部分性葡萄胎。

abstractsObjective To investigate the role of p57 and p53 immunohistochemistry in the differential diagnosis of hydropic abortion, partial hydatidiform mole and complete hydatidiform mole.Methods Immunohistochemical stains (EnVision method ) for p57 and p53 were performed in tissue samples of normal placenta chorionic villi (n = 10), abortion chorionic villi (n = 12), partial hydatidiform (n = 23) and complete hydatidiform moles ( n = 20). Results The expression of p57 was predominantly localized in the nuclei of villous cytotrophoblasts and stromal cells. The positive rates of p57 in normal placenta, hydropic abortion and partial hydatidiform mole were 10/10, 12/12, and 100％ (23/23),respectively, with no significant difference among the groups ( P ＞ 0.05 ). However, none of the complete hydatidiform moles analyzed exhibited p57 positivity in cytotrophoblasts and stromal cells. There was a significant difference between partial and complete hydatidiform moles ( P ＜ 0.05 ). The expression of p53 was observed in the nuclei of cytotrophoblastic cells and intermediate trophoblasts. No p53 expression was seen in normal placenta and only 1 of 12 hydropic abortion showed p53 positivity. The positive rates of p53 expression in partial and complete hydatidiform mole were 60.9％ (14/23) and 85.0％ (17/20) respectively. It was significantly higher in partial hydatidiform mole than that in hydropic abortion.A significant difference was also found between partial and complete hydatidiform moles ( P ＜ 0.05 ).Conclusions Our findings confirm that p57 immunohistochemistry assists the differential diagnosis of complete hydatidiform mole from partial hydatidiform mole. Expression of p53 may be helpful in distinguishing partial hydatidiform mole from hydropic abortion.