Advances in the molecular biology of gestational trophoblastic disease.
Gestational trophoblastic diseases are a heterogeneous pool of clinically and histopathologically defined entities with two clinically relevant features: reproductive failure and a high neoplastic potential. Here we review recent advances in understanding the biology and natural history of the most common form of trophoblastic disease, hydatidiform mole, with an emphasis on the clinical implications for patient management. There are no reliable genetic markers for predicting which subset of moles will behave aggressively, nor are there molecular diagnostic methods at present that offer advances over traditional histopathology. The predominant genetic finding in complete and partial hydatidiform moles is an imbalance of parental chromosomes, completely androgenetic (paternal) in the former and an extra paternal haploid set in the latter. This lack or imbalance of a maternal genomic contribution probably changes the gene expression since there is no evidence of gene mutation in these lesions.
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts 02115.
D J
DJ
Roberts
G L
GL
Mutter
D000818:Animals; D006063:Chorionic Gonadotropin / Q000097:blood; D004195:Disease Models, Animal; D005260:Female; D006580:Genetic Carrier Screening; D005819:Genetic Markers; D005820:Genetic Testing / Q000379:methods; D015894:Genome, Human; D006801:Humans; D006828:Hydatidiform Mole / Q000097:blood / Q000175:diagnosis / Q000235:genetics* / Q000503:physiopathology / Q000628:therapy; D051379:Mice; D011003:Ploidies; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011247:Pregnancy; D011519:Proto-Oncogenes / Q000235:genetics; D014594:Uterine Neoplasms / Q000097:blood / Q000175:diagnosis / Q000235:genetics* / Q000503:physiopathology / Q000628:therapy
D006063:Chorionic Gonadotropin; D005819:Genetic Markers