Immunohistochemical Study of Hydatidiform Mole in Ahmadu Bello University Teaching Hospital Zaria: A Ten-Year Review

Abstract

Background: Morphological examination still forms the main diagnostic tool in the differential diagnosis of molar pregnancies. However,  there may be inter and intra observer variability in differentiating partial from complete moles, and hydropic abortions from partial  moles. The study was aimed at confirming the diagnoses of hydatidiform moles over a ten-year period using p57KIP2 and Ki-67  immunohistochemical markers. Methods: All morphologically diagnosed cases of hydatidiform moles from 1st January 2006 to 31st  December 2015 formed the study materials. The total number of deliveries within the study period was obtained from the obstetrics and  gynaecology department. All the relevant request cards, tissue blocks and slides stained with Haematoxylin and Eosin (H&E) were  retrieved from the departmental records and stained with p57KIP2 and Ki-67 immunohistochemical stains. Results: There were one hundred (100) histologically diagnosed cases of hydatidiform moles during the period of the study, of these 71 (71 %) met inclusion  criteria. The ages-ranged from 15 to 50 years with a mean age of 29.6 + 1SD years. The highest prevalence was in the 2nd decade of life.  The initial H&E diagnosis was 51 partial and 20 complete moles. Of the 71 cases of hydatidiform-moles analysed, 48 (67.6%) showed  positivity for both p57 and Ki-67 immunostains and were classified as partial moles, whereas 23 (32.4%) were complete-moles for being  negative for p57 immunohistochemical marker. No cases of hydropic abortions were seen. Conclusion: This study showed that  hydatidiform-mole affected women more in their 2nd decade of life. Partial-mole is commoner than complete-mole, and with  immunohistochemical markers such as p57 and Ki-67, it is easier to confirm the diagnosis of molar gestations and differentiate between   partial-mole, hydropic-abortion, and complete-mole.