Diagnostic value of glycophorin-A in comparison with P57 immunohistochemical staining method in differentiating complete and partial molar pregnancies

Ann Diagn Pathol. 2021 Aug:53:151769. doi: 10.1016/j.anndiagpath.2021.151769. Epub 2021 Jun 9.

Abstract

Introduction: Current histomorphological criteria in distinguishing two subtypes of hydatidiform moles has considerable inter-observer variability and limitations. In this regard, ancillary studies can aid pathologist to obtain an accurate diagnosis. Herein, we evaluated the utility of Glycophorin-A (GLA) in differentiating complete and partial moles.

Materials and methods: In this case-control study, formalin-fixed paraffin-embedded blocks of 47 patients with pathologic diagnosis of complete and 42 partial hydatidiform moles were included and the diagnoses were confirmed by immunohistochemistry (IHC) for P57. Sections from all samples were stained for GLA using IHC method. Using 2 × 2 tables, the sensitivity, specifity, Positive and Negative Predictive Values (PPV and NPV) as well as accuracy of GLA were determined.

Results: Primary pathologic diagnosis was changed in 7.1% and types of hydatidiform mole were specified in 11.9% of the cases after review of the slides and IHC study for P57. NRBCs were found in 52.7% of the PM cases and none of CMs by pathologist in H&E sections. IHC study for GLA revealed positive result in one case of complete moles (2%) and 31 case of partial mole samples (73.8%). It was negative in 98% of the complete mole and 11 (26.2%) of partial mole cases.

Discussion: The results of this study showed a significant association between GLA immunoreactivity and type of molar pregnancy. Diagnostic sensitivity, specificity and accuracy of this marker for discrimination of molar pregnancy were 73.8%, 98% and 86.5%, respectively. Therefore, this marker can be utilized in differentiating partial and complete hydatidiform mole.

Keywords: Complete mole; Glycophorin-A; Partial mole.

MeSH terms

  • Adult
  • Case-Control Studies
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Cross-Sectional Studies
  • Cyclin-Dependent Kinase Inhibitor p57 / metabolism*
  • Diagnosis, Differential
  • Female
  • Gestational Age
  • Glycophorins / metabolism*
  • Humans
  • Hydatidiform Mole / diagnosis*
  • Hydatidiform Mole / metabolism
  • Hydatidiform Mole / pathology*
  • Immunohistochemistry / methods*
  • Iran / epidemiology
  • Observer Variation
  • Predictive Value of Tests
  • Pregnancy
  • Retrospective Studies
  • Sensitivity and Specificity
  • Staining and Labeling / methods

Substances

  • CDKN1C protein, human
  • Chorionic Gonadotropin, beta Subunit, Human
  • Cyclin-Dependent Kinase Inhibitor p57
  • Glycophorins