Expressions of proliferation markers (Ki-67, proliferating cell nuclear antigen, and silver-staining nucleolar organizer regions) and of p53 tumor protein in gestational trophoblastic disease.
OBJECTIVE
This study was undertaken to determine whether the expressions of 3 proliferation markers (Ki-67, proliferating cell nuclear antigen, and silver-staining nucleolar organizer regions) and of p53 tumor protein could differentiate spontaneous abortions from gestational trophoblastic diseases and also discriminate among gestational trophoblastic disease subgroups.


METHODS
Twenty-two partial hydatidiform moles, 17 complete hydatidiform moles, 6 invasive hydatidiform moles, and 20 nonhydropic spontaneous abortions (control group) were evaluated by means of immunohistochemical techniques with antibodies to Ki-67, proliferating cell nuclear antigen, and p53. One-step silver staining was used to detect silver-staining nucleolar organizer regions.


RESULTS
The expressions of Ki-67, proliferating cell nuclear antigen, silver-staining nucleolar organizer regions, and p53 were significantly higher in the gestational trophoblastic disease group than in the control group. The results of linear discriminant analysis showed that silver-staining nucleolar organizer region count had the highest sensitivity and specificity (93.3% and 100%, respectively) for distinguishing gestational trophoblastic disease from spontaneous abortion. Sensitivity and specificity for discriminating gestational trophoblastic disease from spontaneous abortion increased to 100% when all four markers were used together. Proliferating cell nuclear antigen was found to be the best discriminating variable for differentiating among gestational trophoblastic disease subgroups.


CONCLUSIONS
Our findings suggest that expressions of Ki-67, proliferating cell nuclear antigen, silver-staining nucleolar organizer regions, and p53 may aid in the diagnosis of gestational trophoblastic diseases. These fairly rapid, simple, and economic techniques could serve as a useful adjunct to conventional methods in the diagnosis of gestational trophoblastic diseases.
Department of Obstetrics and Gynecology, School of Medicine, Ankara University, Turkey.
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Kale
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Söylemez
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Ensari
D000022:Abortion, Spontaneous / Q000473:pathology; D000293:Adolescent; D000328:Adult; D002455:Cell Division; D002467:Cell Nucleus / Q000737:chemistry; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000276:immunology / Q000473:pathology*; D002820:Hydatidiform Mole, Invasive / Q000276:immunology / Q000473:pathology; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis*; D009697:Nucleolus Organizer Region / Q000648:ultrastructure*; D011247:Pregnancy; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*; D012680:Sensitivity and Specificity; D016622:Silver Staining; D014327:Trophoblasts / Q000473:pathology; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D014594:Uterine Neoplasms / Q000276:immunology / Q000473:pathology*
D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen; D016159:Tumor Suppressor Protein p53