Background: A diverse range of conditions linked to an
abnormal trophoblast growth are collectively known as
gestational trophoblastic disease (GTD), which are classified
into: tumor-like lesions, molar pregnancies and gestational
trophoblastic neoplasms. Aim of the work: to study
Immunohistochemical expression of VEGF, BCL-2, p63 and
serum β‑hCG in hydropic abortion, molar pregnancy &
choriocarcinoma to elucidate their role in pathogenesis and
diagnosis in these entities. Material and Methods: This
retrospective Immunohistochemical study of VEGF, BCL-2, p63
& serum β‑hCG- was carried upon 65 selected cases of
gestational trophoblastic diseases. Results: VEGF was increased
gradually from hydropic abortion, molar pregnancy to
choriocarcinoma (P=0.000). While BCL-2 and p63 were
downregulated markedly from hydropic abortion to be weakly
or negatively expressed for choriocarcinoma cases (p=0.000).
Serum β‑hCG also increased in the same pattern as VEGF (P
=0.000). BCL-2 & p63 and β‑hCG are more sensitive (100% &
90% & 100%) and specific (56.4%, 100%, 99%, respectively) in
diagnosis of choriocarcinoma. BCL-2 & p63- were highly
sensitive markers (81.8% & 100%) in differentiating hydropic
abortion from molar pregnancy. Conclusion: VEGF, BCL-2, p63
expression and elevated serum β‑hCG level might have role in
gestational trophoblastic disease pathogenesis and progression.
Combined expression of BCl-2, p63 and high β‑hCG, might be
useful to differentiate choriocarcinoma from other gestational
trophoblastic diseases and hence target therapy. BCl-2, p63 could
be used as markers for early diagnosis of molar pregnancy. |
