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Microsatellite DNA Genotyping and Flow Cytometry Ploidy Analyses of Formalin-fixed Paraffin-embedded Hydatidiform Molar Tissues
Published on: October 20, 2019
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Ki-67 expression in hydatidiform moles and hydropic abortions
Alireza Khooei1, Fatemeh Atabaki Pasdar2, Alireza Fazel3
1Department of Pathology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Iranian Red Crescent Medical Journal
|January 8, 2014
Summary
Ki-67 protein expression shows significant differences between hydatidiform moles and hydropic abortions, but overlaps prevent its use for differential diagnosis. This biomarker cannot reliably distinguish complete from partial hydatidiform moles.
Area of Science:
- Reproductive biology and pathology
- Immunohistochemistry
- Gynecologic oncology
Background:
- Accurate diagnosis of hydatidiform moles is crucial for patient management and risk assessment of persistent gestational trophoblastic disease.
- Histomorphological diagnosis of hydatidiform moles faces challenges due to poor interobserver and intraobserver reproducibility.
- Sub-classification into complete and partial hydatidiform moles is clinically significant but diagnostically difficult.
Purpose of the Study:
- To investigate the utility of Ki-67 protein expression in differentiating hydatidiform moles from non-molar specimens.
- To assess if Ki-67 can distinguish between complete and partial hydatidiform moles.
- To evaluate Ki-67 as a potential diagnostic marker in gestational trophoblastic disease.
Main Methods:
- Ki-67 immunohistochemical staining was performed on 19 molar (8 partial, 11 complete) and 10 non-molar (hydropic abortions) tissue samples.
- Ploidy analysis using flow cytometry confirmed diploidy in hydropic abortions and complete moles, and triploidy in partial moles.
- Ki-67 immunoreactivity was quantified in villous cytotrophoblasts, syncytiotrophoblasts, and stromal cells.
Main Results:
- Ki-67 positive cells were primarily observed in villous cytotrophoblasts, with absent staining in syncytiotrophoblasts and occasional weak staining in stromal cells.
- Significant differences in Ki-67 immunoreactivity were found between hydropic abortions and complete moles (P < 0.001), hydropic abortions and partial moles (P = 0.002), and complete and partial moles (P < 0.001).
- Considerable overlap in Ki-67 staining intensity was noted between complete and partial moles, and between partial moles and hydropic abortions, limiting diagnostic utility.
Conclusions:
- Despite statistically significant differences, Ki-67 immunostaining is not sufficiently reliable for distinguishing molar placentas from hydropic abortions.
- Ki-67 expression patterns show significant overlap, making it unsuitable for differentiating between complete and partial hydatidiform moles.
- The diagnostic value of Ki-67 in the differential diagnosis of hydatidiform moles is limited due to overlapping immunoreactivity across different entities.
