Department of pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Department of pathology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
Ann Diagn Pathol. 2021 Aug;53:151769. doi: 10.1016/j.anndiagpath.2021.151769. Epub 2021 Jun 9.
Current histomorphological criteria in distinguishing two subtypes of hydatidiform moles has considerable inter-observer variability and limitations. In this regard, ancillary studies can aid pathologist to obtain an accurate diagnosis. Herein, we evaluated the utility of Glycophorin-A (GLA) in differentiating complete and partial moles.
In this case-control study, formalin-fixed paraffin-embedded blocks of 47 patients with pathologic diagnosis of complete and 42 partial hydatidiform moles were included and the diagnoses were confirmed by immunohistochemistry (IHC) for P57. Sections from all samples were stained for GLA using IHC method. Using 2 × 2 tables, the sensitivity, specifity, Positive and Negative Predictive Values (PPV and NPV) as well as accuracy of GLA were determined.
Primary pathologic diagnosis was changed in 7.1% and types of hydatidiform mole were specified in 11.9% of the cases after review of the slides and IHC study for P57. NRBCs were found in 52.7% of the PM cases and none of CMs by pathologist in H&E sections. IHC study for GLA revealed positive result in one case of complete moles (2%) and 31 case of partial mole samples (73.8%). It was negative in 98% of the complete mole and 11 (26.2%) of partial mole cases.
The results of this study showed a significant association between GLA immunoreactivity and type of molar pregnancy. Diagnostic sensitivity, specificity and accuracy of this marker for discrimination of molar pregnancy were 73.8%, 98% and 86.5%, respectively. Therefore, this marker can be utilized in differentiating partial and complete hydatidiform mole.
目前，区分两种葡萄胎亚型的组织形态学标准存在相当大的观察者间变异性和局限性。在这方面，辅助研究可以帮助病理学家获得准确的诊断。在此，我们评估了糖蛋白 A（GLA）在鉴别完全性和部分性葡萄胎中的作用。
在这项病例对照研究中，纳入了 47 例经病理诊断为完全性葡萄胎和 42 例部分性葡萄胎的福尔马林固定石蜡包埋块，并通过免疫组化（IHC）检测 P57 进行了确诊。所有样本的切片均采用 IHC 方法进行 GLA 染色。通过 2×2 表，确定了 GLA 的敏感性、特异性、阳性预测值（PPV 和 NPV）和准确性。
在重新阅片和 P57 的 IHC 研究后，7.1%的病例改变了主要病理诊断，11.9%的病例明确了葡萄胎的类型。病理学家在 H&E 切片中发现 52.7%的 PM 病例和 0 例 CM 中有 NRBC。GLA 的 IHC 研究显示，1 例完全性葡萄胎（2%）和 31 例部分性葡萄胎样本（73.8%）呈阳性结果。98%的完全性葡萄胎和 11 例（26.2%）部分性葡萄胎呈阴性。
本研究结果表明，GLA 免疫反应与葡萄胎的类型之间存在显著关联。该标志物鉴别葡萄胎的诊断灵敏度、特异性和准确性分别为 73.8%、98%和 86.5%。因此，该标志物可用于鉴别部分性和完全性葡萄胎。
