title: Specific expression patterns of epithelial to mesenchymal transition factors in gestational molar disease.
abstract: BACKGROUND
  The epithelial to mesenchymal transition, a well-known and re-emerging model in pathology, has not been completely investigated in the field of gestational pathology. This study aims at improving the comprehension of this process in molar disease, even looking for new possible immunohistochemical markers.
  
  
  METHODS
  We have analysed the immunohistochemical expression of Twist1 and Snai2, two of the most important transcription factors involved in epithelial to mesenchymal transition, in formalin-fixed paraffin-embedded samples of 23 spontaneous abortive pregnancies, 22 molar pregnancies (10 partial and 12 complete) and 7 term placentas.
  
  
  RESULTS
  Twist1 and Snai2 were highly expressed in stromal villi cells of molar disease. Particularly, Twist1 was highly expressed in complete moles compared to both abortive pregnancies (p < 0.001) and partial moles (p < 0.05). Also Snai2 was more expressed by complete moles, differentiating them from non-molar abortions (p < 0.05).
  
  
  CONCLUSIONS
  On the basis of the known cadherins and claudins expression in these pathologies, our new findings reinforce the hypothesis of the involvement of epithelial to mesenchymal transition in early molar pregnancies and above all in complete moles. Furthermore, we highlighted that in molar disease not only the trophoblast, but even the villi stromal cells, are involved. Thanks to their specificity, furthermore, these Twist1 and Snai2 could be used as additional immunohistochemical tool in the diagnosis of complete molar disease, with Twist1 as the first choice.
authors.affiliation: Department of Pathology and Diagnostics, University of Verona, Verona, Italy. Electronic address: claudio.luchini@katamail.com.
authors.forename: Claudio
authors.initials: C
authors.lastname: Luchini
authors.affiliation: Department of Pathology and Diagnostics, University of Verona, Verona, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Parcesepe
authors.affiliation: ARC-NET Research Center, University of Verona, Verona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mafficini
authors.affiliation: Department of Pathology and Diagnostics, University of Verona, Verona, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Nottegar
authors.affiliation: Department of Pathology and Diagnostics, University of Verona, Verona, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Parolini
authors.affiliation: Department of Medicine (DIMED), University of Padova, Padova, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Veronese
authors.affiliation: Mater Salutis Hospital, Legnago, Verona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Remo
authors.affiliation: Department of Pathology and Diagnostics, University of Verona, Verona, Italy.
authors.forename: Erminia
authors.initials: E
authors.lastname: Manfrin
mesh_terms: D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D058750:Epithelial-Mesenchymal Transition; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000737:chemistry* / Q000473:pathology; D007150:Immunohistochemistry; D009687:Nuclear Proteins / Q000032:analysis*; D011247:Pregnancy; D000071250:Snail Family Transcription Factors; D014157:Transcription Factors / Q000032:analysis*; D051879:Twist-Related Protein 1 / Q000032:analysis*
chemical_list: D015415:Biomarkers; D009687:Nuclear Proteins; C000604408:SNAI2 protein, human; D000071250:Snail Family Transcription Factors; C103173:TWIST1 protein, human; D014157:Transcription Factors; D051879:Twist-Related Protein 1
keywords: Complete mole; EMT; Molar disease; Snai2; Twist; Twist1