Apoptotic activity in gestational trophoblastic disease correlates with clinical outcome: assessment by the caspase-related M30 CytoDeath antibody

Aims: The objective of this study was to assess apoptotic activity in gesta tional trophoblastic disease (GTD) and its prognostic value in hydatidiform mole (HM). Methods and results: Expression of the specific caspase cleavage site withi n cytokeratin 18 was assessed immunohistochemically using the monoclonal an tibody M30 CytoDeath in 12 spontaneous abortions, 22 partial and 57 complet e HM, eight choriocarcinoma (CCA) and 28 normal placentas. The M30 immunore activity occurred predominantly in the syncytiotrophoblasts. A significantl y higher M30 index in HM and CCA was found when compared with normal placen tas and spontaneous abortions (P < 0.001), The M30 index of those HM which spontaneously regressed was significantly higher than those HM which develo ped persistent disease requiring chemotherapy (P < 0.001). The M30 index co rrelated with another apoptotic index previously detected by TdT-mediated d UTP nick-end labelling (TUNEL) (P = 0.007) and the proliferation index asse ssed by the Ki67 antigen (P = 0.034). Conclusions: We conclude that apoptosis is important in the pathogenesis of GTD. Assessment of apoptotic activity in:HM by the M30 index may be consid ered as an alternative prognostic indicator for predicting the clinical beh aviour.