当前位置： SCI文献检索 > ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE期刊下所有文献 > Hydatidiform Moles: Ancillary Techniques to Refine Diagnosis.

Hydatidiform Moles: Ancillary Techniques to Refine Diagnosis.

Abstract：

CONTEXT.—:Distinction of hydatidiform moles from nonmolar specimens and subclassification of hydatidiform moles as complete hydatidiform mole versus partial hydatidiform mole are important for clinical practice and investigational studies. Risk of persistent gestational trophoblastic disease and clinical management differ for these entities. Diagnosis based on morphology is subject to interobserver variability and remains problematic, even for experienced gynecologic pathologists. OBJECTIVES.—:To explain how ancillary techniques target the unique genetic features of hydatidiform moles to establish diagnostic truth, highlight the issue of diagnostic reproducibility and importance of diagnostic accuracy, and illustrate use of p57 immunohistochemistry and polymerase chain reaction-based DNA genotyping for diagnosis. DATA SOURCES.—:Sources are the author's 10-year experience using ancillary techniques for the evaluation of potentially molar specimens in a large gynecologic pathology practice and the literature. CONCLUSIONS.—:The unique genetics of complete hydatidiform moles (purely androgenetic), partial hydatidiform moles (diandric triploid), and nonmolar specimens (biparental, with allelic balance) allow for certain techniques, including immunohistochemical analysis of p57 expression (a paternally imprinted, maternally expressed gene) and genotyping, to refine diagnoses of hydatidiform moles. Although p57 immunostaining alone can identify complete hydatidiform moles, which lack p57 expression because of a lack of maternal DNA, this analysis does not distinguish partial hydatidiform moles from nonmolar specimens because both express p57 because of the presence of maternal DNA. Genotyping, which compares villous and decidual DNA patterns to determine the parental source and ratios of polymorphic alleles, distinguishes purely androgenetic complete hydatidiform moles from diandric triploid partial hydatidiform moles, and both of these from biparental nonmolar specimens. An algorithmic approach to diagnosis using these techniques is advocated.

journal_name

Arch Pathol Lab Med

journal_title

Archives of pathology & laboratory medicine

authors

Ronnett BM

doi

10.5858/arpa.2018-0226-RA

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

1485-1502

issue

eissn

0003-9985

issn

1543-2165

journal_volume

142

pub_type

杂志文章,评审

在线工具

Hydatidiform Moles: Ancillary Techniques to Refine Diagnosis.