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  • Title: [Histopathological features of hydatidiform moles and placenta changes of nonmolar miscarriage in early stage of pregnancy].
    Author: Dong Y, Zhang S, Wang ML, Guo H, Zhang Y, Wang Y, Li T.
    Journal: Beijing Da Xue Xue Bao Yi Xue Ban; 2011 Apr 18; 43(2):194-8. PubMed ID: 21503111.
    Abstract:
    OBJECTIVE: To analyze the histology, immunohistochemistry expression of hydatidiform moles and placenta changes of related conception specimens in early pregnancy stage combined with genotyping detection by fluorescence in situ hybridization method for improving diagnosis of hydatidiform moles. METHODS: A total of 32 cases of hydatidiform moles, problem cases, and hydropic abortuses were collected to study the morphology and the expression of p57KIP2, CD31. Two cases were analyzed the genotype with FISH method. Of the 32 cases, 24 were in early pregnancy stage and 8 in middle pregnancy stage. After validation study, all of the cases were subclassfied into four groups: complete hydatidiform mole (17 cases), partial hydatidiform mole (6 cases), abnormal villous morphology (4 cases) and hydropic abortus (5 cases). RESULTS: (1) The hydrops and central cistern formation were present but not marked in 25% (3/12) early complete hydatidiform moles. All of the cases of complete hydatidiform moles in early pregnancy stage consisted of trophoblastic hyperplasia but with mild nuclear pleomorphism in 75% cases. (2) P57KIP2 negative expression was significantly related with the morphology changes of early CHMs (Pearson correlation: 0.001 and 0.003, P<0.05). (3)The misdiagnosis rate and missing error rate of partial hydatidiform mole and abnormal villous morphology were higher than those of complete hydatidiform mole and hydropic abortus groups, but there was no statistical significance (partial hydatidiform mole 30%, 50%; abnormal villous morphology 75%, 75%; complete hydatidiform mole 15.4%, 35.3%; hydropic abortus 20%, 20%, P>0.05). (4) The genotyping analysis by fluorescence in situ hybridization method could provide support and might be generally performed in research settings. CONCLUSION: Immature blood vessels and excessive stromal karyorrhexis and apoptosis are characteristic features in early complete hydatidiform mole. p57KIP2 is a useful marker in diagnosis of complete hydatidiform mole in early pregnancy stage. The ancillary techniques will facilitate the diagnosis in cases of partial hydatidiform mole/abnormal villous morphology where histological features are usually inconclusive.
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