ORIGINAL ARTICLE
Molecular and histological characteristics of early triploid and partial molar pregnancies
Submission date: 2017-01-08
Final revision date: 2017-04-18
Acceptance date: 2017-04-18
Publication date: 2017-09-01
Pol J Pathol 2017;68(2):138-143
KEYWORDS
TOPICS
ABSTRACT
Molar pregnancy has the highest incidence of all gestational trophoblastic diseases. This is a heterogeneous group of diseases, composed of precancerous lesions and gestational trophoblastic tumours. The hydatidiform mole is characterised by varying degrees of proliferation of syncytiotrophoblastic and cytotrophoblastic cells and stromal oedema. Based on established morphological and cytogenetic criteria, molar pregnancy is divided into partial and complete. The risk of persistent trophoblastic disease is higher in complete moles compared with partial moles.
The aim of this study was to assess the importance of additional molecular methods as a conjunction to the standard histopathological analysis to accurately determine the type and origin of triploidy and to detect partial molar pregnancy.
This study examined a total of 24 cases of triploidy. Apart from the detailed histomorphological analysis, a molecular analysis of the placental tissue and maternal DNA was also performed.
Digynic triploidy was found in 15 cases, whereas diandric triploidy was found in nine of the cases. The results showed that due to the histomorphological overlap between partial molar pregnancy and hydropic abortions, concomitant histopathological analysis of the placental tissue and molecular analysis of the placental and maternal DNA can lead to correct diagnosis.
The aim of this study was to assess the importance of additional molecular methods as a conjunction to the standard histopathological analysis to accurately determine the type and origin of triploidy and to detect partial molar pregnancy.
This study examined a total of 24 cases of triploidy. Apart from the detailed histomorphological analysis, a molecular analysis of the placental tissue and maternal DNA was also performed.
Digynic triploidy was found in 15 cases, whereas diandric triploidy was found in nine of the cases. The results showed that due to the histomorphological overlap between partial molar pregnancy and hydropic abortions, concomitant histopathological analysis of the placental tissue and molecular analysis of the placental and maternal DNA can lead to correct diagnosis.
REFERENCES (27)
1.
Erfanian M, Sharifi N, Omidi AA. P63 and Ki-67 expression in trophoblastic disease and spontaneous abortion. J Res Med Sci 2009; 14: 375-384.
2.
Fernández, J. Cortes R, Salazar A, et al. p57 kip2 immunohistochemistry: ancillary technique in hydatidiform moles diagnosis. BMC Proc 2013; 7: P33.
3.
Golfier F, Clerc J, Hajri T, et al. Contribution of referent pathologists to the quality of trophoblastic diseases diagnosis. Hum Reprod 2011; 26: 2651-2657.
4.
Heidarpour M, Khanahmadi M. Diagnostic value of P63 in differentiating normal gestation from molar pregnancy. J Res Med Sci 2013; 18: 462-466.
5.
Kipp BR, Ketterling RP, Pberg TN, et al. Comparison of fluorescence in situ hybridization, p57 immunostaining, flow cytometry, and digital image analysis for diagnosing molar and nonmolar products of conception. Am J Clin Pathol 2010; 133: 196-204.
6.
Hui P, Baergen R, Cheung ANY, et al. Gestational trophoblastic disease. In: WHO Classification of Tumours of Female Reproductive Organs. Kurman RJ, Carcangiu ML, Herrington CS, et al. (eds). 4th ed. IARC Press, Lyon 2014; 155-168.
7.
Clement PB, Young RH. Atlas of Gynecologic surgical pathology. Clement PB, Young RH. (eds). 3rd ed. Saunders Elsevier, London 2014; 272-286.
8.
Landolsi H, Missaoui N, Yacoubi MT, et al. Assessment of the role of histopathology and DNA image analysis in the diagnosis of molar and non-molar abortion: a study of 89 cases in the center of Tunisia. Pathol Res Pract 2009; 205: 789-796.
9.
Sarmadi S, Izadi-Mood N, Abbasi A, et al. p57KIP2 immunohistochemical expression: a useful diagnostic tool in discrimination between complete hydatidiform mole and its mimics. Arch Gynecol Obstet 2011; 283: 743-748.
10.
Larsen EC, Christiansen OB, Kolte AM, et al. New insights into mechanisms behind miscarriage. BMC Med 2013; 11: 154.
11.
McFadden DE, Jiang R, Langlois S. Dispermy – origin of diandric triploidy: brief communication. Hum Reprod 2002; 17: 3037-3038.
12.
Filges I, Manokhina I, Penaherrera MS, et al. Recurrent triploidy due to a failure to complete maternal meiosis II: whole-exome sequencing reveals candidate variants. Mol Hum Reprod 2015; 21: 339-346.
13.
Zaragoza MV, Surti U, Redline RW, et al. Parental origin and phenotype of triploidy in spontaneous abortions: predominance of diandry and association with the partial hydatidiform mole. Am J Hum Genet 2000; 66: 1807-1820.
14.
Barken SS, Skibsted L, Jensen LN, et al. Diagnosis and prediction of parental origin of triploidies by fetal nuchal translucency and maternal serum free beta-hCG and PAPP-A at 11-14 weeks of gestation. Acta Obstet Gynecol Scand 2008; 87: 975-978.
15.
McFadden DE, Robinson WP. Phenotype of triploid embryos. J Med Genet 2006; 43: 609-612.
16.
Wu Z, Liu N, Zhao Y, et al. Detection of chromosome aneuploidies in spontaneous abortion villus samples by quantitative fluorescence PCR. Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2016; 33: 227-230.
17.
Fleischer J, ShenoyA, Goetzinger K, et al. Digynic triploidy: utility and challenges of noninvasive prenatal testing. Clin Case Rep 2015; 3: 406-410.
18.
Forrester MB, Merz RD. Epidemiology of triploidy in a population-based birth defects registry, Hawaii, 1986-1999. Am J Med Genet A 2003; 119a: 319-323.
19.
Feist H, Caliebe A, Oates J, et al. Partial hydatidiform mole with extensive angiomatoid vessel configuration in a first trimester miscarriage. Int J Gynecol Pathol 2015; 34: 253-256.
20.
Fisher RA, Tommasi A, Short D, et al. Clinical utility of selective molecular genotyping for diagnosis of partial hydatidiform mole; a retrospective study from a regional trophoblastic disease unit. J Clin Pathol 2014; 67: 980-984.
21.
Joergensen MW, Niemann i, Rasmussen AA, et al. Triploid pregnancies: genetic and clinical features of 158 cases. Am J Obstet Gynecol 2014; 211: 370.e1-19.
22.
Joergensen MW, Rasmussen AA, Niemann I, et al. Methylation-specific multiplex ligation-dependent probe amplification: utility for prenatal diagnosis of parental origin in human triploidy. Prenat Diagn 2013; 33: 1131-1136.
23.
Redline RW, Hassold T, Zaragoza M. Determinants of villous trophoblastic hyperplasia in spontaneous abortions. Mod Pathol 1998; 11: 762-768.
24.
Jacobs PA,Szulman AE, Funkhouser J, et al. Human triploidy: relationship between parental origin of the additional haploid complement and development of partial hydatidiform mole. Ann Hum Genet 1982; 46: 223-231.
25.
Lawler SD, Fisher RA, Dent J. A prospective genetic study of complete and partial hydatidiform moles. Am J Obstet Gynecol 1991; 164: 1270-1277.
26.
Petignat P, Billieux MH, Blouin JL, et al. Is genetic analysis useful in the routine management of hydatidiform mole? Hum Reprod 2003; 18: 243-249.
27.
Seckl MJ, Fisher RA, Salerno G, et al. Choriocarcinoma and partial hydatidiform moles. Lancet 2000; 356: 36-39.
| eISSN: | 2084-9869 |
| ISSN: | 1233-9687 |
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