THE ROLE OF DEOXYRIBONUCLEIC-ACID IMAGE CYTOMETRIC AND INTERPHASE CYTOGENETIC ANALYSES IN THE DIFFERENTIAL-DIAGNOSIS, PROGNOSIS, AND CLINICAL FOLLOW-UP OF HYDATIDIFORM MOLES - A REPORT FROM THE CENTRAL MOLAR REGISTRATION IN THE NETHERLANDS

OBJECTIVES: To assess the value of deoxyribonucleic acid ploidy in the different al diagnosis and clinical follow-up of hydatidiform moles, the histopathologic features, deoxyribonucleic acid ploidy, and clinic al follow-up were compared in 347 cases: 143 complete mcles, 52 partia l moles, and 152 abortions, of which 56 cases were hydropic abortions with histologic features of triploidy but lacked trophoblastic hyperpl asia. STUDY DESIGN: In all cases deoxyribonucleic acid image cytometry was performed, and in 85 of these cases interphase cytogenetics was a lso performed. RESULTS: With use of deoxyribonucleic acid image cytome try and interphase cytogenetics, a bimodal polyploid deoxyribonucleic acid pattern was present in 97% of complete moles, 27% of partial mole s, and 4% of abortions. All these cases of partial mole were reclassif ied to complete mole on the basis of this deoxyribonucleic acid patter n and the histopathologic features in spite of the presence of fetal b lood cells, amnion, or yolk sac. Deoxyribonucleic acid triploidy was f ound in 95% of the remaining partial moles, in 77% of hydropic abortio ns with histologic features of triploidy, and in 14% of the remaining abortions. Reliable differentiation between deoxyribonucleic acid trip loid partial moles and hydropic abortions with histologic features of triploidy was not possible on basis of the histopathologic features (t rophoblastic hyperplasia) or 3.5c exceeding rates. Deoxyribonucleic ac id diploidy was found in 1% of complete moles, 23% of hydropic abortio ns with features of triploidy, and 78% of the remaining abortions. Deo xyribonucleic acid tetraploidy was rarely found (1% of complete moles, 2% of partial moles, 1% of abortions). Persistent gestational trophob lastic disease developed in 33% of the bimodal deoxyribonucleic acid p olyploid cases (all complete moles), in 1% of the diploid cases (conce rning one of the two diploid complete moles), and in 1% of the triploi d cases (partial moles). CONCLUSION: Deoxyribonucleic acid analysis is essential in the diagnosis of hyclatidiform moles to decide on clinic al follow-up.