Gestational trophoblastic diseases

Current Opinion in Obstetrics and Gynecology

Volumn 8, Issue 1, 1996, Pages 79-82

  Lage, Janice M ^a,c   Bagg, Adam ^a   Berchem, Guy J ^b  

^a GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b GEORGETOWN UNIVERSITY   (United States)

^c GEORGETOWN UNIVERSITY MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

DNA CONTENT; DOPPLER ECHOGRAPHY; FLOW CYTOMETRY; FLUORESCENCE IN SITU HYBRIDIZATION; HISTOPATHOLOGY; HUMAN; IMMUNOHISTOCHEMISTRY; PRIORITY JOURNAL; REVIEW; TROPHOBLASTIC DISEASE;

EID: 0029940131     PISSN: 1040872X     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001703-199602000-00017     Document Type: Review

References (26)

1. Howat AJ, Beck S, Fox H, Harris SC, Hill AS, Nicholson CM, Williams RA: Can histopathologists reliably diagnose molar pregnancy? J Clin Pathol 1993, 46:599-602.
2. Fukunaga M, Ushigome S, Endo Y: Incidence of hydatidiform mole in a Tokyo hospital: a 5-year (1989 to 1993) prospective, morphological and flow cytometric study. Hum Pathol 1995, 26:758-764. An interesting study reviewing the incidence of partial and complete molar pregnancies in a large Tokyo hospital over a 5-year period. In a retrospective review of the preceding 10 years, the authors discovered that partial mole was commonly underdiagnosed.
3. Lage JM, Mark SD, Roberts DJ, Goldstein DP, Bernstein MR, Berkowitz RS: A flow cytometric study of 137 fresh hydropic placentas: correlation between types of hydatidiform moles and nuclear DNA ploidy. Obstet Gynecol 1992, 79:403-410.
4. Conran RM, Hitchcock CL, Popek EJ, Norris HJ, Griffin JL, Geissel A, McCarthy WF: Diagnostic considerations in molar gestations. Hum Pathol 1993, 24:41-48.
5. Fukunaga M, Ushigome S, Fukunaga M, Sugishita M: Application of flow cytometry in diagnosis of hydatidiform moles. Modern Pathol 1993, 6:353-359.
6. van de Kaa C, Hanselaar AGJM, Hopman AHN, Nelson KAM, Peperkamp AR, Gemmink JH, Beck JLM, de Wilde PCM, Ramaekers FCS, Vooijs GP: DNA cytometric and interphase cytogenetic analyses of paraffin-embedded hydatidiform moles and hydropic abortions. J Pathol 1993, 170:229-238.
7. Heatley M: Fetal tissue as a diagnostic aid in hydatidiform mole. Br J Obstet Gynaecol 1994, 101:448-449. This study looked at a crucial diagnostic factor, the presence of fetal tissues, in partial mole. Only 12% of such cases, much fewer than expected, had recognizable fetal tissues.
8. Szulman AE, Philippe E, Boue JG, Boue A: Human triploidy: association with partial hydatidiform moles and nonmolar conceptuses. Hum Pathol 1981, 12:1016-1021.
9. Cheville JC, Greiner T, Robinson RA, Benda JA: Ploidy analysis by flow cytometry and fluorescence in situ hybridization in hydropic placentas and gestational trophoblastic disease. Hum Pathol 1995, 26:753-757. This very interesting and informative study found the technique of fluorescence in-situ hybridization useful in distinguishing hydropic placentas and hydatidiform moles.
10. Bocklage TJ, Smith HO, Bartow SA: Distinctive flow histogram pattern in molar pregnancies with elevated maternal serum human chorionic gonadotropin levels. Cancer 1994, 73:2782-2790. These authors found that the flow cytometric DNA histograms contained additional diagnostic information beyond determination of nuclear DNA ploidy which appeared useful for distinguishing hydropic pregnancies from hydatidiform moles. S-phase fractions of hydatidiform moles versus hydropic spontaneous abortuses were not significantly different.
11. Topalovski M, Hankin R C, Michael C, Hunter SV, Edwards AM, Chen JC: Ploidy analysis of products of conception by image and flow cytometry with cytogenetic correlation. Am J Clin Pathol 1995, 103:409-414. DNA content was determined by both flow cytometry and image analysis methods in 19 hydropic placentas and found to be 100% concordant.
12. Chen RJ, Huang SU, Chow SN, Hsieh CY, Hsu HC: Persistent gestational trophoblastic tumour with partial hydatidiform mole as the antecedent pregnancy. Br J Obstet Gynaecol 1994, 101:330-334. This large study of 207 women with partial molar pregnancy from a reference center in Taiwan found persistent GTD in 2.9%. Three were triploid, two diploid, and one of unknown ploidy. One of the women with diploid PM required multiagent chemotherapy.
13. Rodriguez GC, Hughes CL, Soper JT, Berchuck A, Clarke-Pearson DL, Hammond CB: Serum progesterone for the exclusion of early pregnancy in women at risk for recurrent gestational trophoblastic neoplasia. Obstet Gynecol 1994, 84:794-797.
14. van Nostrand KM, Lucci JA, Liao SY, DiSaia PJ: Primary lung choriocarcinoma masquerading as a metastatic gestational neoplasm. Gynecol Oncol 1994, 53:361-365. Very interesting clinicopathologic case report discussing primary lung choriocarcinoma with emphasis on excluding metastatic GTD.
15. Dessouky DA: Metastatic trophoblastic neoplasm, report of a case with a delay in diagnosis resulting from an unusual presentation. J Reprod Med 1994, 39:403-407. Though this may well be a case of metastatic partial mole, with the very high serum BhCG, I would want to review the slides or have additional information confirming triploidy before including this case among the few reports of metaslatic disease following partial molar pregnancy.
16. Wisdom SJ, Irvine GA, Gray C, Dryburgh F, Greet IA: Moles and sandwiches. Br J Obstet Gynaecol 1994, 101:455-456. The authors discuss the laboratory anomaly known as hook effect wherein a sandwich assay gives a false negative result because the test reagents (α and BhCG antibodies) are overwhelmed by very high antigen (hCG) concentration.
17. Hsieh FJ, Wu CC, Lee CN, Chen TM, Chen CA, Chen FC, Chen CL, Hsieh CY: Vascular patterns of gestational trophoblastic tumors by color Doppler ultrasound. Cancer 1994, 74:2361-2365. Interesting modality seemingly able to distinguish various uterine patterns of GTD based on vascularity. In the 11 out of 28 cases with histopathologic confirmation, lacunar vascular patterns correlated with invasive mole whereas compact type represented chonocarcinoma. Correlation with clinical factors was demonstrated.
18. Hsieh FJ, Wu CC, Chen CA, Chen TM, Hsieh CY, Chen HY: Correlation of uterine hemodynamics with chemotherapy response in gestational trophoblastic tumors. Obstet Gynecol 1994, 83:1021-1025.
19. Tepper R, Shulman A, Altaras M, Goldberger S, Maymon R, Holzinger M, Beyth Y: The role of color Doppler flow in the management of nonmetastatic gestational trophoblastic disease. Gynecol Obstet Invest 1994, 38:14-17.
20. Cheung ANY, Ngan HYS, Collins RJ, Wong YL: Assessment of cell proliferation in hydatidiform mole using monoclonal antibody MIB1 to Ki-67 antigen. J Clin Pathol 1994, 47:601-604. A large study of 87 hydatidiform moles from Hong Kong. Unfortunately, percentage MIB1 staining did not correlate with persistent disease.
21. Badonnel Y, Barbe F, Legagneur H, Poncelet E, Schweitzer M: Inhibin as a marker for hydatidiform mole: a comparative study with the determinations of intact human chorionic gonadotrophin and its free β-subunit Clin Endocrinol 1994, 41:155-162. Serum levels of inhibin, free βhCG and intact hCG were compared in five women with hydatidiform mole. Intact hCG determination was the most effective in detecting persistent disease.
22. Cao H, Lei ZM, Rao CV: Transcriptional and posttranscriptional mechanisms in epidermal growth factor regulation of human chorionic gonadotropin (hCG) subunits and hCG receptor gene expression in human choriocarcinoma cells. Endocrinology 1994, 135:962-970. Using the JEG-3 choriocarcinoma cell line, these investigators demonstrated that epidermal growth factor stimulated production of α and β hCG mRNA. decreased production of hCG/LH receptor mRNA. and stabilized hCG/LH receptor protein.
23. ••]. JAR choriocarcinoma cell lines demonstrated loss of the ability to self-regulate hCG production.
24. DeVries C, Escobedo A, Ueno H, Houck K, Ferrara N, Williams LT: The fms-like tyrosine kinase, a receptor for vascular endothelial growth factor. Science 1992, 225:989-991.
25. Charnock-Jones DS, Sharkey AM, Boocock CA, Ahmed A, Plevin R, Ferrara N, Smith SK: Vascular endothelial growth factor receptor localization and activation in human trophoblast and choriocarcinoma cells. Biol Reprod 1994, 51:524-530. Messenger RNA is produced for a receptor binding vascular endothelial growth factor in the cytotrophoblastic shell, cell columns and extravillous trophoblast. Vascular endothelial growth factor may play a role in implantation site physiology.
26. Ariel I, Lustig O, Oyer CE, Elkin M, Gonik B, Rachmilewitz J, Biran H, Goshen R, de Groot N, Hochberg A: Relaxation of imprinting in trophoblastic disease. Gynecol Oncol 1994, 53:212-219. Genomic imprinting - a most fascinating topic - results in the selective, preordained expression of certain alleles based on parental origin. In this study encompassing the full range of trophoblastic neoplasia, genomic imprinting of the H19 gene was relaxed in the malignant, non-villous trophoblastic lesions and in two out of four CM.