Immunohistochemistry Study of and Expression in Trophoblastic Tissue and Their Predictive Values in Diagnosing Malignant Progression of Simple Molar Pregnancy.

BACKGROUND

Finding a tumor marker to predict the aggressive behavior of molar pregnancy in early stages has yet been a topic for studies.

OBJECTIVES

In this survey we planned to study patients with molar pregnancy to 1) assess the and expression in trophoblastic tissue, 2) to study the relationship between their expression intensity and progression of a molar pregnancy to gestational trophoblastic neoplasia, and 3) to determine a cut off value for the amount of and expression which might correlate with aggressive behavior of molar pregnancy.

PATIENTS AND METHODS

In a prospective cross sectional study by using a high accuracy technique EnVision system for immunohistochemistry staining of molar pregnancy samples, we evaluated and expression in cytotrophoblast and syncytiotrophoblast and the correlation of their expression with progression of molar pregnancy to gestational trophoblastic neoplasia (GTN). Normal prostatic tissue and Breast cancer tissue were used as positive controls.

RESULTS

We studied 28 patients with simple molar pregnancy (SMP) and 30 with GTN. Cytotrophobalst had significantly higher expression of and and syncytiotrophoblast had greater expression of in GTN group as compared to SMP group. The cut off values for percentage of positive immunostained cytotrophoblast and syncytiotrophoblast were 5.5% and 2.5%. In positive membranous stained cytotrophoblast the cut off was 12.5%.

CONCLUSIONS

Our data suggests that over expression of and is associated with malignant progression of molar pregnancy. We encountered that high expression of and in trophoblastic cells could predict gestational trophoblastic neoplasia during the early stages.