Localization of telomerase hTERT protein and survivin in placenta: Relation to placental development and hydatidiform mole

Objective: To find if a difference in telomerase or survivin expression exi sts between non-neoplastic tissues and hydatidiform moles, and explore expr ession of those proteins in normal placental development, post-term gestati on, and preeclampsia. Methods: Formalin-fixed placental tissues were selected from collections of the Department of Pathology at the University of Colorado. Five specimens of each trimester, five each of preeclamptic and post-term placentas, and 2 3 molar pregnancies were selected. The telomerase catalytic protein hTERT w as localized in placental tissues using the catalyzed signal amplification system, and survivin was localized by conventional immunoperoxidase method. Staining was graded on a scale of zero to 4. Results: hTERT staining was detected in sections of 42 of 48 specimens (23 of 23 hydatidiform moles, 19 of 25 nonneoplastic placental tissues). The in tensity of staining for hTERT was higher in hydatidiform moles (mean 3.3, m edian 3) compared with levels in non-neoplastic placental tissues (mean 0.9 2, median 1) (P <.001). Survivin was detected in 39 of 48 specimens (22 of 23 hydatidiform moles, 17 of 25 non-neoplastic placental tissues). Compared with nonneoplastic tissues (mean 0.88, median 1), survivin levels were ele vated in hydatidiform moles (mean 1.35, median 1) (P =.031). Conclusion: Survivin and telomerase were increased in hydatidiform moles, s uggesting that regulation of apoptosis and stabilization of telomere length might be involved in neoplastic transformation of the placenta. The patter ns of expression observed for survivin and telomerase in nonneoplastic plac ental tissues suggest that the control of apoptosis and stabilization of te lomeric DNA might also be involved in normal gestational development. (Obst et Gynecol 2001;97:965-70. (C) 2001 by The American College of Obstetrician s and Gynecologists.).