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目的探讨p21在妊娠滋养细胞疾病（GTD）中的表达及其在疾病发生、发展中的作用。方法：用免疫组化SP法对10例早孕（6～12周）人工流产绒毛，40例葡萄胎，10例侵蚀性葡萄胎发6例绒毛膜癌组织进行了p21蛋白测定。结果：p21在4种不同组织中的阳性表达中分别为70％、75％、100％、100％；p21在葡萄胎和早孕绒毛之间表达无差异（P＞0．05），而在侵蚀性葡萄胎、绒毛膜癌与早孕绒毛之间存在差异（均为P＜0．05）。葡萄胎组织中，p21染色强度与组织分级无相关性（均为P＞0．05）；p21染色在良性葡萄胎中比以后恶变的葡萄胎中表达高，存在差异（P＜0．05）。结论（Ⅰ）p21与GTD的发展呈正相关，在妊娠滋养细胞肿瘤（GTT）中可能存在Ras基因突变，突变后的Rasp21表达增加，降解减慢，持续传递细胞增殖信息，有促进细胞增殖的效应；（2）在葡萄胎组织中，p21高表达的病人预后良好，因而p21对判断葡萄胎的预后可能具有一定意义。
Objective To investigate the expression of p21 in gestational trophoblastic disease (GTD) and its role in the pathogenesis and development of the disease. Methods: Immunohistochemical SP method was used to detect p21 protein in 10 cases of early abortion (6-12 weeks) aborted villi, 40 cases of hydatidiform mole, and 10 cases of aggressive hydatidiform mole with choriocarcinoma. RESULTS: The positive expression of p21 in 4 different tissues was 70%, 75%, 100%, 100%, respectively; there was no difference in the expression of p21 between hydatidiform mole and early pregnancy villi (P>0.05). There was a difference between villous moles, choriocarcinoma, and early pregnancy villi (all P<0.05). In hydatidiform mole, there was no correlation between p21 staining intensity and tissue grading (all P>0.05); p21 staining was higher in benign hydatidiform mole than later malignant hydatidiform mole (P<0.05). . Conclusion (I) p21 is positively correlated with the development of GTD. Ras gene mutation may be present in gestational trophoblastic neoplasia (GTT). The expression of Rasp21 increases after mutation and slows down the degradation. It will continue to transmit cell proliferation information and promote cell proliferation. (2) In hydatidiform mole, patients with high expression of p21 have a good prognosis, so p21 may have a certain significance for judging the prognosis of hydatidiform mole.