Cases Of Complete Hydatidiform Mole Research Articles

Epidemiological and morphological pattern of complete hydatidiform mole in Aminu Kano Teaching Hospital, Kano Northwestern Nigeria

Background: Complete hydatidiform mole (CHM) is the most common form of non-neoplastic gestational trophoblastic diseases (GTD) that is associated with progression to choriocarcinoma without prompt intervention. The objectives of this study is to morphologically analyze all cases of complete hydatidiform mole in Aminu Kano Teaching Hospital using set down criteria, look at the epidemiological pattern and compare with similar studies in order to stimulate proper identification from other forms of moles, hence reduce morbidity and mortality associated with the known complication of progressing to deadly Choriocarcinoma. Material and Methods: This was a retrospective study of all molar specimens submitted to Histopathology Pathology Department of Aminu Kano Teaching Hospital, Kano between 1st January 2015 and 31st December 2016. Formalin-fixed paraffin-embedded tissue blocks and corresponding Haematoxylin and Eosin (H&E) stained slides were retrieved. Cases with final diagnosis of complete mole were selected for further detailed microscopic evaluations. The collected data were presented using simple frequency tables and figures including photomicrographs of representative lesions. Results: There were sixty-seven cases of complete hydatidiform mole during the study period out of the 61,780 deliveries, giving an approximate incidence of 1:1000 deliveries in Kano metropolis and its environs. The peak incidence was observed in women between 20- 24 years of age with majority presenting between 11-14weeks of pregnancy. The ratio of complete to partial mole was approximately 3:1. Constant morphologic features associated with CHM includes; villous enlargement, trophoblastic hyperplasia, round shape chorionic villi and fibromyxoid stroma. Least prominent feature of CHM is myxoid stromal type. Conclusion: Complete hydatidiform occurs commonly in the gestational ages of between eleven to fourteen weeks; need histopathologic evaluations and prompt intervention to avoid consequences of both immediate complication such as invasive mole and long-term complication of choriocarcinoma. Keywords: Hydatidiform Mole, Complete Mole, Choriocarcinoma

A Rare Case of Large Hydatidiform Mole Mimicking a Term Pregnancy

Molar pregnancy is a type of abnormal pregnancy that usually presents with amenorrhea, vaginal bleeding and elevated serum ß-hCG levels. We report a rare case of complete hydatidiform mole occurring in a 46-year-old P2L2 lady who presented with a term size uterus and elevated serum ß-hCG level (> 15,00,000 per deciliter, anemia (hemoglobin: 8.1 g/dL), difficulty in breathing and minimal vaginal bleeding. During the course of her evaluation, she had profuse vaginal bleeding, she underwent suction and evacuation, but bleeding was not controlled despite measures to control it. She was given uterotonics and antifibrinolytic agents and uterine artery ligation. But was proceeded with emergency hysterectomy for uncontrolled hemorrhage. The content of suction and evacuation was vesicles with blood clots and histopathology was reported as complete hydatidiform mole. The patient received a total of 4 units of packed red blood cells. She was discharged from hospital on 5th postoperative day and was followed up serial serum ß-hCG level. Therefore, complete mole can present with enlarged uterus, vaginal bleeding and anemia. It is also important to note that intractable bleeding following suction and evacuation not being controlled with uterotonics and antifibrinolytic agents and uterine artery ligation may require hysterectomy to save the patient’s life.

Neutrophil/lymphocyte ratio and other blood cell component counts are not associated with the development of postmolar gestational trophoblastic neoplasia.

To relate preevacuation platelet count and leukogram findings, especially neutrophil/lymphocyte ratios (NLR) and platelet/lymphocyte ratios with the occurrence of gestational trophoblastic neoplasia (GTN) after complete hydatidiform mole (CHM) among Brazilian women. Retrospective cohort study of patients with CHM followed at Rio de Janeiro Federal University, from January/2015-December/2020. Before molar evacuation, all patients underwent a medical evaluation, complete blood count and hCG measurement, in addition to other routine preoperative tests. The primary outcome was the occurrence of postmolar GTN. From 827 cases of CHM treated initially at the Reference Center, 696 (84.15%) had spontaneous remission and 131 (15.85%) developed postmolar GTN. Using optimal cut-offs from receiver operating characteristic curves and multivariable logistic regression adjusted for the possible confounding variables of age and preevacuation hCG level (already known to be associated with the development of GTN) we found that ≥2 medical complications at presentation (aOR: 1.96, CI 95%: 1.29-2.98, p<0.001) and preevacuation hCG ≥100,000 IU/L (aOR: 2.16, CI 95%: 1.32-3.52, p<0.001) were significantly associated with postmolar GTN after CHM. However, no blood count profile findings were able to predict progression from CHM to GTN. Although blood count is a widely available test, being a low-cost test and mandatory before molar evacuation, and prognostic for outcome in other neoplasms, its findings were not able to predict the occurrence of GTN after CHM. In contrast, the occurrence of medical complications at presentation and higher preevacuation hCG levels were significantly associated with postmolar GTN and may be useful to guide individualized clinical decisions in post-molar follow-up and treatment of these patients.

Hydatidiform Mole; Histological Types and Age Distribution in Basrah

Background Hydatidiform mole (HM) is a placental pathology, which is a form of gestational trophoblastic disease (GTD). HM is classified into complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM). The incidence of molar pregnancy varies according to the geographical area. It is found to be higher in developing countries. Age is a risk factor for developing HM. In this study, we aim to determine the frequency of hydatidiform mole among cases of early trimester evacuation specimens and its relation to patient's age at Basrah maternity and paediatric hospital and Al- Mosawi private hospital. Patients and Methods This was a descriptive retrospective study for a four-year period; all cases of early trimester evacuation specimens were from January 1, 2017, to December 31, 2020. All specimens were fixed in 10% formalin and dehydrated in graduated alcohol, (5) micron thickness sections were obtained, stained with hematoxylin and eosin and examined, and cases of CHM, PHM and RPOG were analyzed. Results A total of 216 evacuation specimens were examined, and the patients age ranged from 14–50 years. Among these, 78.2% of patients were between 20 and 30 years. The percentage of RPOC was 54.2%, while that of CHM was 19.4% and that of PHM was 26.4%. The maximum cases of complete and partial mole were in the 20–30 years age group. Conclusions The frequency of HM was high compared to many other studies.

Epidemiological aspects and diagnostic accuracy of morphological diagnosis of hydatidiform mole using p57kip2 immunostain in Nnewi, South-East Nigeria – A multicenter study

Introduction: There have been numerous studies on hydatidiform mole (HM) in Nigeria, but some lacked histological diagnosis, and others did not differentiate complete hydatidiform mole (CHM) from partial hydatidiform mole (PHM). In addition, none of these studies involved immunohistochemical (IHC) diagnosis or assessed the accuracy of morphologic diagnosis of CHM. The objective of this study is to determine the epidemiology and accuracy of morphologic diagnosis of CHM using p57KIP2 IHC stain. Materials and Methods: The paraffin blocks of histologically diagnosed cases of CHM and PHM seen at two histopathology laboratories in Nnewi, South-East Nigeria, were retrieved from the archives. IHC staining for p57KIP2 was done. Results: In this study, we reviewed and reclassified 54 cases of routinely stained HMs as 15 (27.8%) CHMs and 39 (72.2%) PHMs. However, following IHC staining, we further reclassified them as 21 (38.9%) CHMs and 33 (61.1%) PHMs. Discordant histopathological diagnosis between routine staining with hematoxylin and eosin (H and E) and IHC staining with p57KIP2 was identified in eight cases (which constitutes 14.8% of the studied cases): one case was a false-positive diagnosis, while the remaining seven cases were false-negative diagnosis. Thus, the sensitivity and specificity of histopathological diagnosed cases of CHM by H and E were 66.7% and 97%, respectively, with a positive predictive value of 93.3%, negative predictive value of 82.1%, and total accuracy of 85.2%. Conclusions: Morphology alone is suboptimal for accurate diagnosis of CHM. We therefore strongly recommend the routine use of p57KIP2 immunostain in all suspected cases of HM.

Complete hydatidiform mole in a 52-year-old postmenopausal woman: A case report and literature review

Benign gestational trophoblastic disease generally occurs in women of reproductive age and is extremely rare in postmenopausal women. Here, the authors describe a case of complete hydatidiform mole in a 52-year-old postmenopausal woman with a history of lower abdominal bloating and vaginal bleeding. The paper summarizes the clinical manifestations, physiopathology, diagnosis, and treatment options for gestational trophoblastic disease in postmenopausal women. This study highlights that gestational trophoblastic disease can occur in postmenopausal women and that it is important to include it in the differential diagnosis of postmenopausal bleeding, to prevent delay in treatment.

Loss of Selenoprotein Iodothyronine Deiodinase 3 Expression Correlates with Progression of Complete Hydatidiform Mole to Gestational Trophoblastic Neoplasia.

To investigate if differences in imprinting at tropho-microRNA (miRNA) genomic clusters can distinguish between pre-gestational trophoblastic neoplasia cases (pre-GTN) and benign complete hydatidiform mole (CHM) cases at the time of initial uterine evacuation. miRNA sequencing was performed on frozen tissue from 39 CHM cases including 9 GTN cases. DIO3, DLK1, RTL1, and MEG 3 mRNA levels were assessed by qRT-PCR. Protein abundance was assessed by Western blot for DIO3, DLK1, and RTL1. qRT-PCR and Western blot were performed for selenoproteins and markers of oxidative stress. Immunohistochemistry (IHC) was performed for DIO3 on an independent validation set of clinical samples (n = 42) and compared to normal placenta controls across gestational ages. Relative expression of the 14q32 miRNA cluster was lower in pre-GTN cases. There were no differences in protein abundance of DLK1 or RTL1. Notably, there was lower protein expression of DIO3 in pre-GTN cases (5-fold, p < 0.03). There were no differences in mRNA levels of DIO3, DLK1, RTL1 or MEG 3. mRNA levels were higher in all CHM cases compared to normal placenta. IHC showed syncytiotrophoblast-specific DIO3 immunostaining in benign CHM cases and normal placenta, while pre-GTN cases of CHM lacked DIO3 expression. We describe two new biomarkers of pre-GTN CHM cases: decreased 14q32 miRNA expression and loss of DIO3 expression by IHC. Differences in imprinting between benign CHM and pre-GTN cases may provide insight into the fundamental development of CHM.

Video Hysteroscopy in the Diagnosis of Molar Pregnancy in two Challenging Situations: Complete Mole with Normal hCG and Partial Mole with Early Gestational Age

To present the first hysteroscopic findings of 2 cases of complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM) within the context of the patients' clinical histories. Presentation of 2 hysteroscopic videos with narration of the intrauterine findings of molar pregnancy (MP) from Rio de Janeiro Gestational Trophoblastic Disease Reference Center. MP is characterized by abnormal fertilization that generates 2 clinical syndromes: CHM and PHM [1]. In the first case, the patient was aged 50 years, and hysteroscopy was indicated to assess abnormal uterine bleeding in the presence of normal serum human chorionic gonadotropin (hCG) and transvaginal ultrassonography showing an endometrial cavity with heterogeneous content. Hysteroscopy found translucent hydropic structures diagnosed as CHM. The negative hCG value was due to the hook effect (hCG after dilution: 2 240 000 IU/L). In the second case, an 18-year-old patient underwent hysteroscopy to assess the endometrial cavity with retained abortion at 7 weeks in which, during conservative management, the hCG level increased over 4 weeks from 25 000 IU/L to 58 000 IU/L. Hysteroscopy visualized the embryo with its umbilical cord and hydatidiform vesicles diagnosed as PHM. MP can be an incidental finding during hysteroscopy for abnormal uterine bleeding or retained abortion [2-4]. Knowing its morphology during hysteroscopy is helpful for the correct management of this uncommon clinical situation. Hysteroscopy as an adjunct diagnostic tool (not as first-line treatment for MP) can be of significant benefit in challenging clinical scenarios. Further studies should assess the possible risk of spreading molar cells into the peritoneal cavity owing to hysteroscopic fluid.

Gestational trophoblastic disease in Switzerland: retrospective study of the impact of a regional reference centre.

The European Society of Medical Oncology (ESMO) recommends that countries should have reference centres to provide adequate diagnosis and treatment of gestational trophoblastic disease. A trophoblastic disease centre in the French-speaking part of Switzerland was inaugurated in 2009. The objectives of this study were to report the activity of the centre during the last 10 years and analyse gestational trophoblastic disease outcomes. This was a retrospective study with data collected from all cases of gestational trophoblastic disease referred to the centre from 2009 to 2018. All histological specimens as well as data for treatment and follow-up of gestational trophoblastic disease and neoplasia were reviewed. Clinical features, including age, prognostic score and International Federation of Gynecology and Obstetrics (FIGO) stages (in the case of gestational trophoblastic neoplasia), human chorionic gonadotropin (hCG) follow-up, treatment and outcome were reported. The centre registered 354 patients, and these patients presented 156 cases of partial hydatidiform moles, 163 cases of complete hydatidiform moles and 14 cases of gestational trophoblastic neoplasia. During follow-up, 35 gestational trophoblastic neoplasms were diagnosed after hCG persistence. After pathology review, the overall agreement rates between our centre and a participating provider hospital was 82%. Methotrexate was the first line of single-agent chemotherapy for most patients, with resistance rates of 23%. Multi-agent chemotherapy was used as first-line treatment for five patients. None of the patients followed up by the centre died from gestational trophoblastic disease. This study reflects the activity of the Swiss trophoblastic disease centre from the French-speaking part of Switzerland created in 2009, and its role as local and national reference centre, in terms of global health, for women with gestational trophoblastic disease.

P57kip2 immunohistochemical marker as a diagnostic tool for cases of hydatidiform moles in a tertiary health facility in Southwestern Nigeria.

Hydatidiform mole (HM) is the most common gestational trophoblastic disease. P57kip2 has been reported to be helpful in differentiating between partial and complete HMs. The study aims to evaluate the P57kip2 immunohistochemical (IHC) marker as a useful ancillary investigation to differentiate complete hydatidiform mole (CHM) from partial hydatidiform mole (PHM). A retrospective study of all histologically diagnosed HM cases over a 20 year period was undertaken. Clinicopathological parameters were extracted from the surgical day book and medical record archives. Archival haematoxylin- and eosin-stained slides and formalin-fixed paraffin-embedded tissue blocks of all cases of HM diagnosed within the study period were retrieved and reviewed. Cases of HM were reclassified using the P57kip2 IHC marker. The data obtained were analysed using the SPSS version 23. One hundred cases of HMs were studied. CHM accounted for 68%, while PHM accounted for the remaining 32%. The incidence of HM was 2.98 cases per 1000 deliveries. The ratio of CHM to PHM was found to be 2.1:1. Seventy-two per cent of the cases were diagnosed in the first trimester, while the remaining 28% were diagnosed in the second trimester of pregnancy. Based on the P57kip2 IHC staining pattern, HM cases were finally reclassified into 68 cases of CHM and 32 cases of PHM. The age range for all the HM cases was 18-50 years with the majority of the cases seen in the third and fourth decades of life. P57kip2 could be useful as an ancillary investigation in confirming the diagnosis of CHM and differentiating it from PHM, particularly in difficult and challenging cases.

Clinical characteristics and diagnosis of early hydatidiform mole

Objective: To evaluate the clinical characteristics and diagnostic strategies of early hydatidiform mole. Methods: A retrospective cohort study was conducted of 526 women with hydatidiform mole who underwent suction curettage and were confirmed by histopathology in Dalian Maternal and ChildHealth Care Hospital from Feb. 2013 to Feb. 2018, including 484 women with gestational age less than or equal to 12 weeks (the early group) and 42 women with gestational age greater than 12 weeks (the late group). The clinical characteristics between the two groups were compared, and the pathological diagnosis and pre-evacuation ultrasound examination of the early group were further discussed. Results: Compared with the late group, the clinical characteristics of the early group tended to be atypical, and the incidence of vaginal bleeding, excessive uterine size, theca lutein cysts (>6 cm) and pregnancy complications decreased significantly (all P<0.05). The serum level of β-hCG in the early group was significantly lower than that in the late group (Z=-2.382, P=0.017). While there was no significant difference in the pre-evacuation ultrasound detection rate between the two groups (53.5% vs 66.7%; χ(2)=2.697, P=0.101). Five hundred and fifteen patients completed the follow-up, and 38 patients with post-mole neoplasia were all cured. There was no significant difference in the malignant transformation rate of hydatidiform mole between the two groups (7.0% vs 11.9%; χ(2)=0.745, P=0.388). In the early group, 302 cases of complete hydatidiform mole (CHM), 179 cases of partial hydatidiform mole (PHM) and 3 cases of unclassified hydatidiform mole (UHM) were histologically diagnosed, according to pathological morphology combined with p57(KIP2) immunohistochemical staining. Compared with pathological diagnosis, the overall pre-evacuation ultrasound detection rate in the early hydatidiform mole was 53.5% (259/484), which was significantly better for complete (78.1%, 236/302) versus partial (11.7%, 21/179) hydatidiform moles (χ(2)=199.224, P<0.01). There was significantly weak negative correlation between the overall ultrasound detection rate and gestational age of hydatidiform mole (r=-0.211, P<0.01). The gestational age of early PHM was significantly longer than that of CHM (68.0 vs 58.5 days; Z=-8.048, P<0.01). Conclusions: The clinical presentations of early hydatidiform mole are not typical. Although ultrasound examination identifies only about half of hydatidiform moles, ultrasonography is still an important auxiliary examination method. Morphological examination combined with p57(K)IP2 immunohistochemical staining could effectively diagnose early hydatidiform mole, so as to reduce the missed diagnosis of hydatidiform mole.

P57 in Hydatidiform Moles: Evaluation of Antibodies and Expression in Various Cell Types.

The protein p57 is encoded by CDKN1C. This gene is known to be paternally imprinted and maternally expressed in cytotrophoblasts and villous stromal cells. We present a method for evaluating p57 antibodies (Abs) in hydatidiform mole (HM) and demonstrate the results for 4 p57 Abs in various cell types. Five cases of complete HM, diploid with 2 paternal genome sets (CHM;PP), 5 cases of partial HM, triploid with 2 paternal and 1 maternal genome sets (PHM;PPM), and 5 cases of non-HM, with diploid biparental genomes (non-HM;PM) were stained with p57 Abs: 57P06, EP183, KP10, and KP39. Assessment of the fraction of nuclei stained, and the intensity of staining of the nuclei and cytoplasm was performed. For evaluation of the Abs, the observations in cytotrophoblasts, villous stromal cells, maternal decidual cells, and intermediate trophoblasts were scored. The fraction of stained nuclei in cytotrophoblasts and villous stromal cells and the staining of cytoplasm showed to be important parameters in the evaluation of the Abs. 57P06 was evaluated as optimal. KP10 showed moderate cytoplasmatic staining in maternal decidual cells and intermediate trophoblasts, and was evaluated as good. EP183 was evaluated as poor, primarily due to nuclear staining in ≥10% of the villous stromal cells in CHM;PP. KP39 was evaluated as poor, primarily due to strong cytoplasmatic staining in some cytotrophoblasts and villous stromal cells. A structured testing of p57 for diagnosing HM is recommended. No nuclear staining was observed in syncytiotrophoblasts of CHM;PP, indicating that in syncytiotrophoblasts also, CDKN1C is paternally imprinted.

A case report of hydatidiform mole:A Diagnostic Dilemma

Molar pregnancy is a part of gestational trophoblastic disease, and can rarely be associated with hyperthyroidism. We report a case of complete hydatidiform mole who initially presented as one and half month amenorrhea and bleeding per vaginum, with an ultrasonography report suggestive of multiple gestational sacs without any fetal pole, leading to a provisional diagnosis of threatened abortion. Then, routine investigations were done and raised beta HCG value were suggestive of choriocarcinoma and hydatidiform mole which was later confirmed by histopathological examination.

Recurrent complete hydatidiform mole: where we are, is there a safe gestational horizon? Opinion and mini-review.

Benign hydatidiform mole, complete or partial, is the most common type of gestational trophoblastic disease (GTD) characterised by excessive trophoblastic proliferation and abnormal embryonic development. Although most complete hydatidiform moles (CHMs) are diploid androgenetic, a few cases of CHMs are biparental, characterised by recurrence and familial clustering. In these rare cases, mutations in NLRP7 or KHDC3L genes, associated with maternal imprinting defects, have been implicated. Current data regarding future pregnancy options in hydatidiform moles are discussed and our opinion is presented based on an incidence that took place in our hospital with a woman with consecutive molar pregnancies. In recurrent hydatidiform moles, DNA testing should be performed and when NLRP7 or KHDC3L mutation are detected, oocyte donation should be proposed as an option to maximise woman's chances of having a normal pregnancy.

Diagnostic Utility of Twist1, Ki-67, and E-Cadherin in Diagnosing Molar Gestations and Hydropic Abortions.

This study aims to assess whether the expression of Twist1, Ki-67, and E-cadherin can guide the differential diagnosis of complete hydatidiform mole (CHM), partial hydatidiform mole (PHM), and hydropic abortion (HA). Differential expression of Twist1, Ki-67, and E-cadherin was analyzed in gestational products from 55 cases of CHM, PHM, and HA using immunohistochemistry. Prior to analysis, the studied cases were confirmed for their diagnosis by flow cytometric assessment of DNA ploidy and p57 immunostaining. Twist1 expression can distinguish CHM from PHM and HA with 100% sensitivity, 100%, specificity, 100% positive predictive value (PPV), and 100% negative predictive value (NPV). Furthermore, combined Ki-67 and E-cadherin expression could differentiate PHM and HA with 100% sensitivity, 93.3% specificity, 92.3% PPV, and 100% NPV. Twist1 expression is a highly reliable marker for the diagnosis of CHM, where combined Ki-67 and E-cadherin immunoreactivity can distinguish PHM from nonmolar pregnancies.

Unusual twin pregnancy: complete hydatidiform mole with coexistent normal fetus

The authors present a case of complete hydatidiform mole and coexisting fetus (CHMCF) in which mole gestation caused a placenta previa; with a posterior preterm premature rupture of membranes (PPROM) and ending in the 28h week of gestation due to acute chorioamnionitis, obtaining a live preterm newborn.

A case of complete hydatidiform mole with coexistent fetus developing hypertension and acute heart failure

A case of complete hydatidiform mole with coexistent fetus developing hypertension and acute heart failure

A Case of Persistent Gestational Trophoblastic Disease after Complete Hydatidiform Mole

Gestational trophoblastic disease is an abnormal proliferations of trophoblastic tissue during pregnancy. Persistent gestational trophoblastic t umor develops in about 20% after evacuation of complete mole. Following evacuation of hydatidiform mole, the interpretation of serial serum human chorionic gonadotropin (hCG) regression patterns is important in monitoring the course of the disease. Because it is the most reliable and sensitive method for the early detection of gestational trophoblastic disease. We describe an uncommon case of complete hydatidiform mole in a 48-year-old woman, who has presented to us with complaints of bleeding. She experienced after the evacuation of a complete mole and no decreased in hCG levels over four consecutive serum hCG measurements. The patient underwent hysterectomy due to leiomyoma. Finally, pathologic diagnosis was confirmed persistent gestational trophoblastic disease. Key words: Hydatidiform mole; Gestational trophoblastic disease

P57Kip2 immunostaining, a diagnostic marker in differentiating complete hydatidiform mole from its mimics

Background and objective: The distinction of hydatidiform mole from hydropic abortion remains a problem because of interobserver and intraobserver variability. This study aimed to determine the utility of p57Kip2 as a diagnostic marker in differentiating complete hydatidiform mole from its mimics. Methods: A total of 97 formalin fixed paraffin embedded material including forty cases of complete hydatidiform mole, 36 cases of partial hydatidiform mole and 21 cases of hydropic abortion were selected randomly from the files of histopathology laboratory of Maternity Teaching Hospital in Erbil. The samples were reviewed by two pathologists, afterward; immunohistochemical staining was performed by using a p57Kip2 marker. We considered p57Kip2 positive only if nuclear p57Kip2 staining was identified in at least 10% or more of all in a tissue section. Results: Negative immunostaining was seen in 77.5% of the complete hydatidiform mole in both villous cytotrophoblast and stromal cells. In contrast, 86.1% of partial hydatidiform mole showed positive immunostaining for p57Kip2. All cases of hydropic abortion 100% were positive for p57Kip2 immunostaining. In all gestations, p57Kip2 was strongly expressed in decidua which served as internal positive control. The concordance between the initial histological diagnosis and p57Kip2 immunostaining was statistically significant (P <0.001). Conclusions: p57Kip2 immunostaining is a highly sensitive and specific marker for diagnosis and classification of hydatidiform mole. p57Kip2 staining has the advantage of differentiating hydropic abortuses from the complete hydatidiform mole.

Comparison of p57, c-erbB-2, CD117, and Bcl-2 expression in the differential diagnosis of hydatidiform mole and hydropic abortion.

To explore the utility of p57, c-erbB-2, CD 117, and Bel-2 immunostaining in the differential diagnosis of complete hydatidiform mole (CHM), partial hydatidiform mole (PHM), and hydropic abortion (HA). Immunohistochemical expression of the p57, c-erbB-2, CD117, and Bel-2 proteins were investigated semi-quantitatively using paraffin-embedded tissue sections from histologically unequivocal cases of CHM (n = 20), PHM (n = 23), and HA (n = 17). All cases of CHM exhibited a striking absence of p57 expression. The percentage of positive p57 staining was similar between PHMs (73.9%) and HAs (76.5%) (p >0.05). The comparison of c-erbB-2 expression revealed a significantly higher percentage of positive c-erbB-2 staining in CHMs (45%) compared with that in PHMs (8.7%) and HAs (5.9%) (p = 0.006 and 0.01, respectively). The CD 117 expression pattern (immunoreactivity score, percentage of positive cells, and staining intensity) was significantly lower in HAs compared with that in PHMs and CHMs (p < 0.05 for all). A significantly increased Bel-2 expression pattern was observed in HAs compared with that in PHMs and CHMs (p < 0.05 for all). Immunohistochemical examination of p57, c-erbB-2, CD 117, and Bel-2 expression represents a relatively simple, reliable, and cost-efficient procedure to definitively distinguish among CHM, PHM, and HA.