Journal of Histopathology and Cytopathology
January 2024 volume 8 issue 1
Original Contribution
Association between Histomorphological Types of Hydatidiform Mole and the Expression of Ki67 Immunohistochemical Marker as well as β-hCG Level Status
1. *Dr. Sonia Hossain, MD (Pathology), Pathologist, Department of Pathology, Dhaka Medical College.
sondhisoniahossain69@gmail.com
2. Professor Roksana Jeba, Professor & Head, Department of Pathology, Dhaka Medical College.
3. Dr. Zubaida Bahroon Khan, MD (Pathology), Associate Professor, Department of Pathology, Dhaka Medical College.
*For correspondence
Abstract
Background: Hydatidiform mole (HM) is the most common type of gestational trophoblastic disease which is sub-classified into complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM). Accurate subclassification of HM is very important as the development of choriocarcinoma and persistent trophoblastic diseases are more related to CHM than PHM. However, sometimes this subclassification is more challenging only based on histomorphological findings. Because there is considerable intraobserver and interobserver variability, histomorphological findings in conjunction with some complementary methods such as immunohistochemistry and biochemical markers could be helpful in the accurate interpretation of the HMs. The aim of this study was to evaluate the expression of Ki 67 immunostain along with the pretreatment β-hCG level and to identify their association with histomorphological types of hydatidiform mole.
Methods: This cross-sectional observational study was done at Department of Pathology, Dhaka Medical College. The cases were classified into CHM and PHM based on histopathological features. Pretreatment β-hCG level noted and Ki 67 immunohistochemistry was done. The results of the cases were collected and tabulated. Statistical analysis was performed on the tabulated data using Fisher Exact test, Chi-square test and Unpaired t-test.
Results: Out of 50 cases, based on histopathological criteria, 27(54.0%) cases were CHM and 23(46.0%) were PHM. After evaluating Ki67 immunohistochemical staining, among CHM, 23(85.2%) cases showed Ki67 score-3 and 4(14.8%) cases score-2. Out of 23 PHM, 22 (95.7%) cases showed Ki -67 score-2 and 1(4.3%) case showed score-3. These were statistically significant. On the other hand, among the CHM 22 (81.5%) had β-hCG level ≥100000 mIU/ml and 5 (18.5%) had <100000 mIU/ml. Among PHM 2 (8.7%) had β-hCG ≥ 100000 mIU/ml and 91.3% had β-hCG<100000 mIU/ml. It was also statistically significant.
Conclusion: Diagnosis of HM can be improved by Ki67 labeling index and evaluation of pretreatment β-hCG level, which will help in differentiating CHM from PHM. The correct diagnosis is crucial for future treatment and follow-up of the patients.
[Journal of Histopathology and Cytopathology, 2024 Jan; 8 (1):41-48]
DOI: https://www.doi.org/10.69950/jhc.2024.v8.i1.06
Keywords: Hydatidiform mole, Complete hydatidifrom mole, Partial hydatidiform mole, β-hCG, Ki67 Immunomarker
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