Lectin binding as a prognostic indicator in gestational trophoblastic diseases (GTD)

Gestational Trophoblastic Diseases (GTD) is a group of hyperproliferative conditions of the placenta. Very often these can be fatal or recurrent. Presently, no reliable marker is available apart from serum beta HCG levels to identify tumours with a higher aggressive nature, the reduction pattern of the serum beta HCG levels indicating persistence of the disease. This causes a delay of nearly 12-16 weeks in deciding on chemotherapy. In this study, the potential of Jack fruit lectin (JFL) binding as a quick and cheap method of assessing the aggressiveness of the disease immediately after evacuation was evaluated. A significantly higher intensity of lectin binding was noticed in GTD when compared to gestational age related normal placentae. Persisting tumour lesions generally showed intense, diffuse and granular lectin binding and showed significant cytological atypia. The lectin binding score showed close correlation with the regressing pattern of serum beta HCG but not with the initial levels of beta HCG, indirectly pointing to its potential in identifying lesions with high risk of persisting disease. Hence evaluation of the lectin binding characteristics of the lesion immediately after evacuation will be of help in following up these patients closely and planning therapy.