Erol Onur, Süren Dinç, Tutuş Birsel, Toptaş Tayfun, Gökay Ahmet Arda, Derbent Aysel Uysal, Özel Mustafa Kemal, Sezer Cem
Department of Obstetrics and Gynecology, Antalya Training and Research Hospital, Antalya, Turkey.
Department of Pathology, Antalya Training and Research Hospital, Antalya, Turkey.
Pathol Oncol Res. 2016 Jul;22(3):515-21. doi: 10.1007/s12253-015-0031-8. Epub 2015 Dec 18.
The purpose of this study was to investigate the role of E-cadherin, p53, and inhibin-α immunostaining in the differential diagnosis of hydropic abortion (HA), partial hydatidiform mole (PHM), and complete hydatidiform mole (CHM). E-cadherin, p53, and inhibin-α protein expression patterns were investigated immunohistochemically using paraffin -embedded tissue sections from histologically diagnosed cases of HA (n = 23), PHM (n = 24), and CHM (n = 23). Expression patterns of these markers were scored semi-quantitatively according to the staining intensity, percentage of positive cells, and immunoreactivity score. Classification of cases was established on histologic criteria and supported by the molecular genotyping. Immunostaining allowed the identification of specific cell types with E-cadherin, p53, and inhibin-α expression in all cases. E-cadherin expression was detected on the cell surface of villous cytotrophoblasts. We observed a marked decline in the expression of E-cadherin from HAs to PHMs to CHMs. The p53-positive reaction was restricted to the nucleus of villous cytotrophoblasts. Significantly increased p53 expression was observed in CHMs, compared with HAs and PHMs. The expression of inhibin-α was localised in the cytoplasm of villous syncytiotrophoblasts, and the expression of this marker was significantly higher in PHMs and CHMs than HAs. In conclusion, immunohistochemical analysis of E-cadherin, p53, and inhibin-α expression could serve as a useful adjunct to conventional methods in the differential diagnosis of HA, PHM, and CHM.
本研究的目的是探讨E-钙黏蛋白、p53和抑制素-α免疫染色在稽留流产(HA)、部分性葡萄胎(PHM)和完全性葡萄胎(CHM)鉴别诊断中的作用。采用免疫组织化学方法,对经组织学诊断为HA(n = 23)、PHM(n = 24)和CHM(n = 23)的石蜡包埋组织切片进行研究,观察E-钙黏蛋白、p53和抑制素-α蛋白的表达模式。根据染色强度、阳性细胞百分比和免疫反应性评分对这些标志物的表达模式进行半定量评分。病例分类基于组织学标准,并得到分子基因分型的支持。免疫染色可在所有病例中识别出表达E-钙黏蛋白、p53和抑制素-α的特定细胞类型。在绒毛细胞滋养层细胞表面检测到E-钙黏蛋白表达。我们观察到从HA到PHM再到CHM,E-钙黏蛋白的表达明显下降。p53阳性反应局限于绒毛细胞滋养层细胞核。与HA和PHM相比,CHM中p53表达显著增加。抑制素-α的表达定位于绒毛合体滋养层细胞的细胞质中,该标志物在PHM和CHM中的表达明显高于HA。总之,E-钙黏蛋白、p53和抑制素-α表达的免疫组织化学分析可作为HA、PHM和CHM鉴别诊断中传统方法的有用辅助手段。