Expressions of proliferation markers (Ki-67, proliferating cell nuclear antigen, and silver-staining nucleolar organizer regions) and of p53 tumor protein in gestational trophoblastic disease

OBJECTIVE: This study was undertaken to determine whether the expressions o f 3 proliferation markers (Ki-67, proliferating cell nuclear antigen, and s ilver-staining nucleolar organizer regions) and of p53 tumor protein could differentiate spontaneous abortions from gestational trophoblastic diseases and also discriminate among gestational trophoblastic disease subgroups. STUDY DESIGN: Twenty-two partial hydatidiform moles, 17 complete hydatidifo rm moles. 6 invasive hydatidiform moles. and 20 nonhydropic spontaneous abo rtions (control group) were evaluated by means of immunohistochemical techn iques with antibodies to Ki-67, proliferating cell nuclear antigen, and p53 , One-step silver staining was used to detect silver-staining nucleolar org anizer regions. RESULTS: The expressions of Ki-67, proliferating cell nuclear antigen, silv er-staining nucleolar organizer regions, and p53 were significantly higher in the gestational trophoblastic disease group than in the control group. T he results of linear discriminant analysis showed that silver-staining nucl eolar organizer region count had the highest sensitivity and specificity (9 3.3% and 100%, respectively) for distinguishing gestational trophoblastic d isease from spontaneous abortion. Sensitivity and specificity for discrimin ating gestational trophoblastic disease from spontaneous abortion increased to 100% when all four markers were used together. Proliferating cell nucle ar antigen was found to be the best discriminating variable for differentia ting among gestational trophoblastic disease subgroups. CONCLUSION: Our findings suggest that expressions of Ki-67, proliferating c ell nuclear antigen, silver-staining nucleolar organizer regions, and p53 m ay aid in the diagnosis of gestational trophoblastic diseases. These fairly rapid, simple, and economic techniques could serve as a useful adjunct to conventional methods in the diagnosis of gestational trophoblastic diseases .