P57Kip2 immunostaining, a diagnostic marker in differentiating complete hydatidiform mole from its mimics

Ava T. Ismael

doi:10.15218/zjms.2016.0026

Authors

Ava T. Ismael Department of Clinical Analysis, College of Pharmacy, Hawler Medical University, Erbil, Iraq.

DOI:

https://doi.org/10.15218/zjms.2016.0026

Keywords:

Hydatidiform mole, p57Kip2, Hydropic abortion, immunohistochemical study

Abstract

Background and objective: The distinction of hydatidiform mole from hydropic abortion remains a problem because of interobserver and intraobserver variability. This study aimed to determine the utility of p57^Kip2 as a diagnostic marker in differentiating complete hydatidiform mole from its mimics.

Methods: A total of 97 formalin fixed paraffin embedded material including forty cases of complete hydatidiform mole, 36 cases of partial hydatidiform mole and 21 cases of hydropic abortion were selected randomly from the files of histopathology laboratory of Maternity Teaching Hospital in Erbil. The samples were reviewed by two pathologists, afterward; immunohistochemical staining was performed by using a p57^Kip2 marker. We considered p57^Kip2 positive only if nuclear p57^Kip2 staining was identified in at least 10% or more of all in a tissue section.

Results: Negative immunostaining was seen in 77.5% of the complete hydatidiform mole in both villous cytotrophoblast and stromal cells. In contrast, 86.1% of partial hydatidiform mole showed positive immunostaining for p57^Kip2. All cases of hydropic abortion 100% were positive for p57^Kip2 immunostaining. In all gestations, p57^Kip2 was strongly expressed in decidua which served as internal positive control. The concordance between the initial histological diagnosis and p57^Kip2 immunostaining was statistically significant (P <0.001).

Conclusions: p57^Kip2 immunostaining is a highly sensitive and specific marker for diagnosis and classification of hydatidiform mole. p57^Kip2 staining has the advantage of differentiating hydropic abortuses from the complete hydatidiform mole.

Metrics

Metrics Loading ...

References

LeGallo RD, Stelow EB, Ramirez NC, Atkins KA. Diagnosis of hydatidiform moles using p57 immunohistochemistry and HER2 fluorescent in situ hybridization. Am J Clin Pathol 2008; 129:749-55.

Abdou A, Kandil M, El-Wahed MA, Shabaan M, El-Sharkawy M. The diagnostic value of p27 in comparison to p57 in differentiation between different gestational trophoblastic diseases. Fet Ped Pathol 2013; 32:395-411.

Merchant SH, Amin MB, Viswanatha DS, Malhotra RK, Moehlenkamp C, Joste NE. P57Kip2 Immunohistochemistry in early molar pregnancies: Emphasis on it's complementary role in the differential diagnosis of hydropic abortuses. Huma Pathol 2005; 36:180-6.

Fukunga M, Katabuchi H, Nagasaka T, Mikami Y, Minamiguchi S, Lage JM . Interobserver and intaobserver variability in the diagnosis of hydatidiform mole. Am J Surg Pathol 2005; 29:942-7.

Crisp H, Burton JL, Stewart R, Wells M. Refining the diagnosis of hydatidiform mole: image ploidy analysis and p57Kip2immunohistochemistry. Histopathol 2003; 43:363-73.

Fernandez J, Cortes R, Salazar A, Pulido A, Dabed P, Garcia V. p 57 Kip 2 immunohistochemistry: ancillary technique in hydatidiform moles diagnosis. BMC proceeding 2013; 7:33-9.

Castrillon DH, Sun D, Weremowicz S, Fisher RA, Crum CP, Genest DR. Discrimination of complete hydatidiform mole from its mimics by immunohistochemistry of paternally imprinted gene product p57 KIP 2.Am J Surg Pathol 2001; 25:125-30.

Jun SY, Ro JY, Kim KR. p57kip2 is useful in the classification and differential diagnosis of complete and partial hydatidiform moles. Histopathol 2003; 43:7-25.

Maggiori MS, Peres LC. Morphological, immunohistochemical and chromosome in situ hybridization in the differential diagnosis of Hydatidiform Mole and Hydropic Abortion. Europ J Obst Gynecol Repro Biol 2007; 135:170-6.

Chen YX, Shen DH, Gu YQ, Zhong PP, Xie JL, Song QJ. Immunohistochemistry of p57 and p53 protein in differential diagnosis of hydropic abortion, partial and complete hydatidiform mole. Chinese J pathol 2011; 40:694-7.

Landolsi H, Missaoui N, Brahem S, Hmissa S, Gribaa M, Yacoubi MT. The usefulness of p57 (KIP2) immunohistochemical staining and genotyping test in the diagnosis of the hydatidiform mole. Pathol Res Pract 2011; 207:498-504.

Masaharu F. Immunohistochemical characterization of p57 KIP2 expression in early hydatidiform moles. Hum Pathol 2002; 33:1188-92.

García-Barriola V, de Gómez MN, Dickson-González S, Figueira L, Cortés-Charry R. Utility of p57 protein (KIP2) in molar disease to determine its androgenetic origin. J Repr Med 2008; 53:476-80.

McConnell TG, Murphy KM, Hafez M, Vang R, Ronnett BM. Diagnosis and subclassification of hydatidiform moles using p57 immunohistochemistry and molecular genotyping: validation and prospective analysis in routine and consultation practice settings with development of an algorithmic approach. Am J Sur Pathol 2009; 33:805-17.

DeScipio C, Haley L, Beierl K, Pandit AP, Murphy KM, Ronnett BM. Diandric triploid hydatidiform mole with loss of maternal chromosome 11. Am J Surg Pathol 2011; 35:1586-91.

Masoumeh F, Neil JS, Philip MS, Michael JS, Rosemary AF. Mutations in NLRP7 and KHDC3L confer a complete hydatidiform mole phenotype on Digynic triploid conceptions. Hum Mut 2013; 34:301-8.

Banet N, DeScipio C, Murphy KM, Beierl K, Adams E, Vang R. Characteristics of hydatidiform moles: analysis of a prospective series with p57 immunohistochemistry and molecular genotyping. Mod Pathol 2014; 27:238-54.

Srinivasan M, Sedmak D, Jewell S. Effect of fixatives and tissue processing on the content and integrity of nucleic acids. Am J Pathol 2002; 161:1961-71.