Expression of p57 Immunostain in Complete and Partial Hydatidiform Moles

Hydatidiform mole (HM) is a gestational trophoblastic disease characterized by abnormal proliferation of trophoblastic tissue. Accurate subclassification into complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM) is essential, as CHM carries a higher risk of persistent trophoblastic disease and choriocarcinoma. Histopathology alone may be inconclusive due to overlapping features and interobserver variability. p57 immunohistochemistry has emerged as a valuable ancillary tool in differentiating CHM from PHM. This study aimed to evaluate p57 expression across histopathologically diagnosed cases of HM and determine its usefulness as a diagnostic marker.

A cross-sectional observational study was conducted on 57 cases diagnosed as complete, partial, or indeterminate HM from the Bangladesh Medical University (BMU) and private laboratories in Dhaka. All cases were re-evaluated based on defined histopathological criteria. p57 immunohistochemistry was performed in the Department of Pathology, BMU, and staining results were compared across diagnostic groups. Statistical analysis was performed using SPSS Statistics version 22.0 for Windows (IBM Corp., Armonk, NY, USA). A p value <0.05 was considered significant.  Results: Of 57 cases, 36 were histologically diagnosed as CHM, 13 as PHM, and eight as indeterminate. Among CHM, 32 (88.9%) showed negative p57 expression, while four (11.1%) were positive. In PHM cases, nine (69.2%) showed positive expression, and four (30.8%) were negative. Among indeterminate cases, six showed negative expression, and two were positive. p57 expression demonstrated a statistically significant association with final diagnosis, leading to reclassification of cases to 42 CHM and 15 PHM.

p57 immunostaining significantly enhances diagnostic accuracy and reduces ambiguity in differentiating complete from partial HM. Incorporation of p57 evaluation alongside histopathology is recommended for reliable subclassification of HM.