Romaguera Rita L, Rodriguez Maria M, Bruce Jocelyn H, Zuluaga Tania, Viciana Ana, Penalver Manuel A, Mehrdad Nadji
Pathology, University of Miami/Jackson Memorial Medical Center, Miami, Florida 33136, USA.
Fetal Pediatr Pathol. 2004 Mar-Jun;23(2-3):181-90. doi: 10.1080/15227950490890351.
Classification of molar gestations into complete and partial and their differentiation from hydropic abortions traditionally are accomplished by morphology alone. The process sometimes may be inaccurate or inconclusive. With the availability of p57 immunostaining it may be possible to objectively classify these lesions. We used p57 for the differential diagnosis of hydropic abortions and molar gestations and correlated the findings with the clinical outcome of patients in each category. First, 86 cases were originally classified by histomorphology into hydropic abortion (42) and molar gestations (23 complete and 21partial). Based on the pattern of p57 staining the cases were reclassified into 45 hydropic abortions, 15 partial moles and 26 complete moles (3 cases with previous diagnosis of complete mole based on morphology were reclassified as hydropic abortion). Clinical follow-ups ranged from 6-24 months and showed persistent trophoblastic disease in 8 cases (31%) of complete moles and 3 cases (20%) of partial moles (p = 0.47). No hydropic abortion cases demonstrated persistent trophoblastic disease. One patient with partial mole developed choriocarcinoma. This study confirms that p57 objectively distinguishes hydropic abortions from molar gestations (partial and complete moles). This differentiation is clinically relevant since patients with hydropic abortions do not need to be followed while patients with molar gestations do.
传统上，将葡萄胎妊娠分为完全性和部分性，并将其与水肿性流产相鉴别，仅通过形态学来完成。这个过程有时可能不准确或无法得出结论。有了p57免疫染色技术，就有可能对这些病变进行客观分类。我们使用p57对水肿性流产和葡萄胎妊娠进行鉴别诊断，并将结果与每类患者的临床结局相关联。首先，86例病例最初根据组织形态学分为水肿性流产（42例）和葡萄胎妊娠（23例完全性和21例部分性）。根据p57染色模式，这些病例重新分类为45例水肿性流产、15例部分性葡萄胎和26例完全性葡萄胎（3例先前根据形态学诊断为完全性葡萄胎的病例重新分类为水肿性流产）。临床随访时间为6至24个月，结果显示，26例完全性葡萄胎中有8例（31%）和15例部分性葡萄胎中有3例（20%）出现持续性滋养细胞疾病（p = 0.47）。没有水肿性流产病例出现持续性滋养细胞疾病。1例部分性葡萄胎患者发生了绒毛膜癌。本研究证实，p57能客观地区分水水肿性流产与葡萄胎妊娠（部分性和完全性葡萄胎）。这种区分具有临床相关性，因为水肿性流产患者无需随访，而葡萄胎妊娠患者则需要。
