Kavyah R S, Sangeetha Shubha R, Choudhary Shaista, Loganathan Abinaya
Pathology, Dr. B.R. Ambedkar Medical College & Hospital, Bangalore, IND.
Cureus. 2025 May 8;17(5):e83716. doi: 10.7759/cureus.83716. eCollection 2025 May.
Introduction Molar pregnancy (hydatidiform mole) is a premalignant form of gestational trophoblastic disease, occurring in approximately one in 1,000 pregnancies. It is characterized by abnormal swelling of chorionic villi and excessive trophoblastic proliferation. Accurate differentiation between complete hydatidiform moles (CHMs) and partial hydatidiform moles (PHMs) is crucial, as CHMs carry a higher risk of progressing to persistent trophoblastic disease or choriocarcinoma. p57 immunohistochemistry (IHC), regulated by the maternally expressed gene, is a key diagnostic tool due to its distinct expression patterns in different molar subtypes. Methods A prospective observational study was conducted over 18 months at Dr. B.R. Ambedkar Medical College & Hospital, in Bangalore, India, involving 25 cases: 15 clinically diagnosed molar pregnancies and 10 products of conception used as controls. Detailed clinical histories were recorded, followed by histopathological examination and p57 IHC analysis. All cases underwent statistical evaluation. Results Among the 25 cases, 12 (48%) were diagnosed as CHM, three (12%) as PHM, and 10 as non-molar controls. CHM cases showed negative p57 staining in villous cytotrophoblasts, whereas PHM cases exhibited weak to moderate nuclear positivity. Control cases demonstrated strong nuclear positivity. The use of p57 IHC showed a statistically significant correlation (p < 0.001) with accurate differentiation between complete and partial moles. Conclusions This study confirms that p57 IHC is a reliable and effective diagnostic tool for distinguishing between CHM and PHM. Its clear differential staining pattern enhances diagnostic precision, informs clinical decision-making, and minimizes the risk of misdiagnosis, supporting its routine implementation in the evaluation of molar pregnancies.
引言 葡萄胎是妊娠滋养细胞疾病的一种癌前病变形式，在大约每1000次妊娠中发生1例。其特征为绒毛膜绒毛异常肿胀和滋养细胞过度增殖。准确区分完全性葡萄胎（CHM）和部分性葡萄胎（PHM）至关重要，因为CHM发展为持续性滋养细胞疾病或绒毛膜癌的风险更高。由母系表达基因调控的p57免疫组织化学（IHC），因其在不同葡萄胎亚型中的独特表达模式，是一种关键的诊断工具。方法 在印度班加罗尔的B.R. 安贝德卡尔医学院及医院进行了一项为期18个月的前瞻性观察研究，涉及25例病例：15例临床诊断为葡萄胎妊娠，10例妊娠产物用作对照。记录详细的临床病史，随后进行组织病理学检查和p57 IHC分析。所有病例均进行统计学评估。结果 在25例病例中，12例（48%）被诊断为CHM，3例（12%）为PHM，10例为非葡萄胎对照。CHM病例的绒毛细胞滋养层p57染色呈阴性，而PHM病例表现为弱至中度核阳性。对照病例显示强核阳性。使用p57 IHC显示与完全性和部分性葡萄胎的准确区分具有统计学显著相关性（p < 0.001）。结论 本研究证实p57 IHC是区分CHM和PHM的可靠且有效的诊断工具。其清晰的鉴别染色模式提高了诊断准确性，为临床决策提供依据，并将误诊风险降至最低，支持其在葡萄胎妊娠评估中的常规应用。
