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葡萄胎与水肿性流产鉴别诊断中的形态学、免疫组织化学及染色体原位杂交

Morphological, immunohistochemical and chromosome in situ hybridization in the differential diagnosis of Hydatidiform Mole and Hydropic Abortion.

作者信息

Maggiori Mariana S, Peres Luiz C

机构信息

Department of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Avenue Bandeirantes, 3900 Ribeirão Preto, São Paulo 14049-900, Brazil.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2007 Dec;135(2):170-6. doi: 10.1016/j.ejogrb.2007.05.005. Epub 2007 Jun 28.

Abstract

OBJECTIVE

To explore the utility of histological, immunohistochemical and chromosome in situ hybridization (CISH) test in the differential diagnosis of Complete Hydatidiform Mole (CHM), Partial Hydatidiform Mole (PHM) and Hydropic Abortion (HA).

STUDY DESIGN

We analyzed the histological characteristics, p57kip2 and Factor VIII expression and CISH test in 38 cases with some diagnostic concerns, comprising 13 CHM, 14 PHM and 11 HA.

RESULTS

Our results indicate that p57kip2 expression and the ploidy assessed by CISH were essential for the reclassification of 2 cases, one from CHM to PHM and another from PHM to HA, as well as for confirming the previous diagnosis in cases where there were conflicting features. p57kip2 expression is diagnostic if no cells at all present it (CHM) or when there are over 10% of cells expressing it (PHM and HA).

CONCLUSIONS

We concluded that there is no single criterion for the distinction of CHM, PHM and HA. So p57kip2 expression and CISH test can be used in association with the histological findings for the differential diagnosis of the three conditions in cases presenting some concern for definitive diagnosis.

摘要

目的

探讨组织学、免疫组化及染色体原位杂交(CISH)检测在完全性葡萄胎(CHM)、部分性葡萄胎(PHM)及水肿性流产(HA)鉴别诊断中的应用价值。

研究设计

我们分析了38例存在诊断疑问的病例的组织学特征、p57kip2和因子VIII表达及CISH检测结果,其中包括13例CHM、14例PHM和11例HA。

结果

我们的结果表明,p57kip2表达及通过CISH评估的倍性对于2例病例的重新分类至关重要,1例从CHM重新分类为PHM,另1例从PHM重新分类为HA,同时对于存在特征冲突的病例中先前诊断的确认也很重要。如果完全不存在表达p57kip2的细胞(CHM)或超过10%的细胞表达p57kip2(PHM和HA),则p57kip2表达具有诊断意义。

结论

我们得出结论,区分CHM、PHM和HA没有单一标准。因此,在对明确诊断存在疑问的病例中,p57kip2表达和CISH检测可与组织学结果联合用于这三种情况的鉴别诊断。

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