Comparison of fluorescence in situ hybridization, p57 immunostaining, flow cytometry, and digital image analysis for diagnosing molar and nonmolar products of conception.
Pathologic examination of products of conception (POC) is used to differentiate hydropic abortus (HA), partial hydatidiform mole (PM), and complete hydatidiform mole (CM). Histologic classification of POC specimens can be difficult, and ancillary testing is often required for a definitive diagnosis. This study evaluated 66 POC specimens by flow cytometry, digital image analysis, p57 immunohistochemical analysis, and fluorescence in situ hybridization (FISH). The final diagnosis, based on the combined analysis of all test results, included 33 HAs, 24 PMs, and 9 CMs. The p57 immunostain identified 9 CMs that were evaluated as nontriploid by all other techniques. FISH seems to have the best accuracy (100%) for determining whether a specimen contains a triploid chromosome complement. These data suggest that the combination of p57 and FISH seems to be the best ancillary testing strategy to aid pathologists in the appropriate identification of CM, PM, and HA in POC specimens.
Kipp
Benjamin R
BR
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Ketterling
Rhett P
RP
Oberg
Trynda N
TN
Cousin
Margot A
MA
Plagge
Amy M
AM
Wiktor
Anne E
AE
Ihrke
Johnita M
JM
Meyers
Cecelia H
CH
Morice
William G
WG
Halling
Kevin C
KC
Clayton
Amy C
AC
D000028:Abortion, Induced; D000328:Adult; D050761:Cyclin-Dependent Kinase Inhibitor p57 / Q000032:analysis*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis / Q000235:genetics*; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D011003:Ploidies; D011247:Pregnancy
C493964:CDKN1C protein, human; D050761:Cyclin-Dependent Kinase Inhibitor p57