Analysis of p53 expression in partial hydatidiform mole and hydropic abortion

Abstract

BACKGROUND: Gestational trophoblastic disease (GTD) is a heterogeneous group of disorders characterized by abnormal trophoblast tissue. Molar and non-molar hydropic placental changes are the most common forms of GTD. Differential diagnosis of GTD is sometimes problematic. Recently, p53 expression was identified as a good marker for distinguishing GTD types.

AIMS:Comparison of p53 expression in partial hydatidiform mole (PHM) and hydropic abortion.

METHODS: In this prospective cross-sectional study, molar and non-molar hydropic pregnancy specimens were collected. Immunohistochemical staining, based on the Labeled Streptavidin Biotin (LSAB) technique, was carried out on multiple 4mm paraffin block sections prepared from formalin-fixed trophoblastic tissues. Polymer-based Envision was used to assess p53 tumor suppressor protein immunoreactivity. p53 expression was then compared between both groups.

RESULTS: In the study, 40 patients were included: 20 with confirmed PHM and 20 with hydropic pregnancy. p53 protein was positive in 60% of patients with PHM and 25% of patients with hydropic pregnancy. The p53 positive rate was significantly higher in patients with PHM (p = 0.027). Moreover, patients with PHM had a significantly high grade of staining (p<0.001).

CONCLUSION: Our findings indicate that immunohistochemical analysis of p53 protein can be used to distinguish PHM and hydropic pregnancy.

Keywords

Partial hydatidiform mole / hydropic abortion / p53 expression

References

[1] Al-Bozom I A (2000). p53 and Bcl-2 oncoprotein expression in placentas with hydropic changes and partial and complete moles. APMIS, 108(11): 756–760

[2] Chen Y X, Shen  D H, Gu  Y Q, Zhong  P P, Xie  J L, Song  Q J, Zhang  Y L, Wen  J (2011). Immunohistochemistry of p57 and p53 protein in differential diagnosis of hydropic abortion, partial and complete hydatidiform mole. Chin J Pathol (Zhonghua Bing Li Xue Za Zhi), 40(10): 694–697

[3] Almasi A, Almassinokiani  F, Akbari P  (2014). Frequency of molar pregnancies in health care centers of tehran, Iran. J Reprod Infertil, 15(3): 157–160

[4] Berchuck A, Kohler  M F, Marks  J R, Wiseman  R, Boyd J ,  Bast R C  Jr (1994). The p53 tumor suppressor gene frequently is altered in gynecologic cancers. Am J Obstet Gynecol, 170(1 Pt 1): 246– 252

[5] Carey L, Nash  B M, Wright  D C (2015). Molecular genetic studies of complete hydatidiform moles. Transl Pediatr, 4(2): 181–188

[6] Chiu P M, Ngan  Y S, Khoo  U S, Cheung  A N (2001). Apoptotic activity in gestational trophoblastic disease correlates with clinical outcome: assessment by the caspase-related M30 CytoDeath antibody. Histopathology, 38(3): 243–249

[7] Singh Y A, Singh  L S, Singh  L R, Liyak  P, Vaz A (2016) . A study of molar pregnancy at tertiary centre of India. Iosr J Dental Med Sci, 15(9): 49–52

[8] Hasanzadeh M, Sharifi  N, Farazestanian M ,  Nazemian S S ,  Madani Sani F  (2016). Immunohistochemistry study of P53 and C-erbB-2 expression in trophoblastic tissue and their predictive values in diagnosing malignant progression of simple molar pregnancy. Iran J Cancer Prev, 9(3): e4115

[9] Masood S, Kehar  S I, Shawana  S, Aamir I  (2015). Differential expression of p63 in hydropic and molar gestations. J Coll Physicians Surg Pak, 25(3): 198–201

[10] Ngan H Y, Seckl  M J, Berkowitz  R S, Xiang  Y, Golfier F ,  Sekharan P K ,  Lurain J R  (2015). Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynaecol Obstet, 131(Suppl 2): S123–S126

[11] Ozaki T, Nakagawara  A (2011). Role of p53 in cell death and human cancers. Cancers (Basel), 3(1): 994–1013

[12] Rath G, Soni  S, Prasad C P ,  Salhan S ,  Jain A K ,  Saxena S  (2011). Bcl-2 and p53 expressions in Indian women with complete hydatidiform mole. Singapore Med J, 52(7): 502–507

[13] Schammel D P, Bocklage  T (1996). p53 PCNA, and Ki-67 in hydropic molar and nonmolar placentas: an immunohistochemical study. Int J Gynecol Pathol, 15(2): 158–166

[14] Soragni A, Janzen  D M, Johnson  L M, Lindgren  A G, Thai-Quynh Nguyen  A, Tiourin E ,  Soriaga A B ,  Lu J, Jiang  L, Faull K F ,  Pellegrini M ,  Memarzadeh S ,  Eisenberg D S  (2016). A designed inhibitor of p53 aggregation rescues p53 tumor suppression in ovarian carcinomas. Cancer Cell, 29(1): 90–103

[15] Standard Immunohistochemistry Staining Method, Labeled Streptavidin Biotin (LSAB) Method [online]. Available from: URL:http://www.ihcworld.com/_protocols/ general_IHC/standard_lsab_method.htm Accessed Feb 11, 2007

[16] Wei D, Wu  Q, Shi H  (2014). Apoptosis and p53 expression in the placental villi of females with unexplained recurrent spontaneous abortion. Exp Ther Med, 7(1): 191–194

Acknowledgments

We wish to thank all our colleagues at Imam Khomeini and Golestan Hospitals, Ahvaz, Iran.

Compliance with ethics guidelines

The authors declare that they have no conflict of interest. All procedures have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down by the 1964 Declaration of Helsinki and its later amendments. Informed consent was assessed prior to intervention. Details disclosing the identity of the subjects under study were omitted

RIGHTS & PERMISSIONS

2017 Higher Education Press and Springer-Verlag Berlin Heidelberg