title: The immunohistochemical analysis of RCAS1, HLA-G, and B7H4-positive macrophages in partial and complete hydatidiform mole in both applied therapeutic surgery and surgery followed by chemotherapy.
abstract: BACKGROUND
  The suppressive microenvironment developing around the implantating ovum in normal pregnant women may correlate with the development in cancer patients of a suppressive microenvironment of neoplasmatic cells derived from trophoblasts, such as occurs in molar lesions. Macrophages are suitable candidates for mediating not only the balance of the maternal defensive immune responses to external antigens, but also a tolerance to tumor cells. The aim of our study has been to gain information about the expression of RCAS1, B7H4, and HLA-G within the macrophages present in the microenvironment of the molar lesion.
  
  
  METHODS
  We analyzed the immunoreactivity of such antigens as B7H4, RCAS1, and HLA-G on the macrophages present in tissue samples derived from patients on whom curettage was performed after a diagnosis of molar pregnancy. These patients were then divided into two subgroups according to whether or not they required chemotherapy after the surgical procedure.
  
  
  RESULTS
  We observed a statistically significant increase in the RCAS1-positive macrophage infiltration within the microenvironment of the molar lesions in patients with partial hydatidiform mole in comparison with those patients who exhibited complete hydatidiform mole. There were no such differences, however, in the infiltration of HLA-G- and B7H4-positive macrophages between the two groups of patients. Additionally, we showed that RCAS1- and HLA-G-positive macrophages are more distinct in those cases of complete molar pregnancy where chemotherapy was necessary after surgical treatment while no such differences with respect to B7H4-positive macrophages were observed.
  
  
  CONCLUSIONS
  The immune-suppressive endometrial microenvironment represented by suppressive macrophages may have an influence on the clinical course of hydatidiform mole.
authors.affiliation: Gynecology, Obstetrics and Oncology of the Jagiellonian University, Krakow, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Basta
authors.forename: Krystyna
authors.initials: K
authors.lastname: Galazka
authors.forename: Pawel
authors.initials: P
authors.lastname: Mach
authors.forename: Wojciech
authors.initials: W
authors.lastname: Jozwicki
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Walentowicz
authors.forename: Lukasz
authors.initials: L
authors.lastname: Wicherek
mesh_terms: D000951:Antigens, Neoplasm / Q000378:metabolism*; D018122:B7-1 Antigen / Q000378:metabolism*; D005260:Female; D006680:HLA Antigens / Q000378:metabolism*; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I / Q000378:metabolism*; D006801:Humans; D006828:Hydatidiform Mole / Q000188:drug therapy / Q000276:immunology* / Q000601:surgery; D007150:Immunohistochemistry; D008264:Macrophages / Q000276:immunology* / Q000378:metabolism; D011247:Pregnancy / Q000276:immunology; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000276:immunology* / Q000601:surgery
chemical_list: D000951:Antigens, Neoplasm; D018122:B7-1 Antigen; C120762:EBAG9 protein, human; D006680:HLA Antigens; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I