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Suzuki Y, Usui H, Katayama E, Sato A, Nakamura N, Nakada E, Omoto A, Okayama J, Sato M, Nagasawa A, Hirosawa A, Shozu M, Koga K. Single-nucleotide polymorphism array and fluorescence in situ hybridization analysis to decode the cytogenetic profile of atypical partial hydatidiform moles diagnosed by short tandem repeat polymorphism analysis. Genes Chromosomes Cancer 2024; 63:e23220. [PMID: 38780072 DOI: 10.1002/gcc.23220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/28/2023] [Accepted: 12/18/2023] [Indexed: 05/25/2024] Open
Abstract
Accurate diagnosis of partial hydatidiform moles (PHMs) is crucial for improving outcomes of gestational trophoblastic neoplasia. The use of short tandem repeat (STR) polymorphism analysis to distinguish between PHM and hydropic abortuses is instrumental; however, its diagnostic power has not been comprehensively assessed. Herein, we evaluated the diagnostic efficacy of STR in differentiating between PHM and hydropic abortus, thus providing an opportunity for early measurement of human chorionic gonadotropin for PHMs. We reviewed charts of STR polymorphism analysis performed on fresh villous specimens and patient blood samples using a commercial kit for 16 loci. The genetic classification of 79 PHMs was confirmed. STR was reliable in differentiating PHMs when at least 15 loci were available. Typically, PHMs are characterized by their triploidy, including two paternal and one maternal haploid contribution. In our sample, seven PHMs lacked the three-allelic loci, requiring fluorescence in situ hybridization (FISH) analysis to investigate imbalanced biparental conceptus and single-nucleotide polymorphism array analysis to reveal cytogenetic details. Of these PHMs, two, three, and one were identified as androgenetic/biparental mosaics (diploids), monospermic diandric monogynic triploids, and a typical dispermic diandric monogynic triploid, respectively. The remaining case was monospermic origin, but its ploidy details could not be available. Therefore, STR differentiated PHM from a biparental diploid abortus in most cases. However, PHM diagnosis may be compromised when STR is used as the sole method for cases displaying distinct cytogenetic patterns lacking the three-allelic loci, including androgenetic/biparental mosaicism. Therefore, FISH should be considered to confirm the diagnosis.
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Affiliation(s)
- Yoshiya Suzuki
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Hirokazu Usui
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
- Department of Obstetrics and Gynecology, Reproductive Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Eri Katayama
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Asuka Sato
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Natsuko Nakamura
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Emiri Nakada
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Akiko Omoto
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
- Department of Obstetrics and Gynecology, Reproductive Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Jun Okayama
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Mika Sato
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Akiko Nagasawa
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Akiko Hirosawa
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Makio Shozu
- Department of Obstetrics and Gynecology, Reproductive Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kaori Koga
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
- Department of Obstetrics and Gynecology, Reproductive Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
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Usui H, Katayama E, Nakamura N, Koga K. Letter to the editor on Donzel M et al. "Androgenetic/biparental mosaicism in a diploid mole-like conceptus: report of a case with triple paternal contribution". Virchows Arch 2023:10.1007/s00428-023-03669-5. [PMID: 38051350 DOI: 10.1007/s00428-023-03669-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 09/19/2023] [Accepted: 09/29/2023] [Indexed: 12/07/2023]
Affiliation(s)
- Hirokazu Usui
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
- Department of Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan.
| | - Eri Katayama
- Department of Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Natsuko Nakamura
- Department of Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Kaori Koga
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Gynecology, Chiba University Hospital, Chiba University, Chiba, Japan
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Song S, Kim M, Koh JH, Kang OJ, Oh D, Lee SH, Lee SJ, Ahn JW, Roh HJ, Kim KR, Kim JS. Chimeric Singleton Placenta Comprising Placental Mesenchymal Dysplasia and Complete Hydatidiform Mole with Live Birth and Postpartum Diagnosis of Gestational Trophoblastic Neoplasia. Gynecol Obstet Invest 2023; 88:314-321. [PMID: 37442099 DOI: 10.1159/000531864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023]
Abstract
INTRODUCTION Placental mesenchymal dysplasia (PMD) is a benign lesion that is often misdiagnosed as complete (CHM) or partial hydatidiform mole. PMD usually results in live birth but can be associated with several fetal defects. Herein, we report PMD with CHM in a singleton placenta with live birth. CASE PRESENTATION A 34-year-old gravida 2, para 1, living 1 (G2P1L1) woman was referred on suspicion of a molar pregnancy in the first trimester. Maternal serum human chorionic gonadotrophin levels were increased during early pregnancy, with multicystic lesions and placentomegaly observed on ultrasonography. Levels decreased to normal with no fetal structural abnormalities observed. A healthy male infant was delivered at 34 gestational weeks. Placental p57KIP2 immunostaining and short tandem repeat analysis revealed three distinct histologies and genetic features: normal infant and placenta, PMD, and CHM. Gestational trophoblastic neoplasia was diagnosed and up to fourth-line chemotherapy administered. CONCLUSION Distinguishing PMD from hydatidiform moles is critical for avoiding unnecessary termination of pregnancy. CHM coexisting with a live fetus rarely occurs. This case is unique in that a healthy male infant was born from a singleton placenta with PMD and CHM.
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Affiliation(s)
- Seungyeon Song
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Misung Kim
- Department of Pathology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Ji Hye Koh
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Ok Ju Kang
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - DaSol Oh
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Sang-Hun Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Jun-Woo Ahn
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Hyun-Jin Roh
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Kyu-Rae Kim
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jeong Sook Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
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Usui H. Auxiliary and experimental diagnostic techniques for hydatidiform moles. J Obstet Gynaecol Res 2022; 48:3077-3086. [PMID: 36098274 DOI: 10.1111/jog.15422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/28/2022] [Indexed: 11/30/2022]
Abstract
Hydatidiform moles are classified into complete hydatidiform moles (CHMs), which are androgenetic and diploid, and partial hydatidiform moles (PHM), which are triploid with two paternal chromosomes and one maternal chromosome. The incidence of gestational trophoblastic neoplasia differs substantially between CHM and PHM. However, they are occasionally difficult to diagnose. In this review, auxiliary and experimental methods based on cytogenetic features and advanced molecular detection techniques applied to the diagnosis and analysis of hydatidiform moles are summarized, including basic principles, characteristics, and clinical implications. Short tandem repeat polymorphism analysis is considered the gold standard for the genetic diagnosis of hydatidiform moles. In clinical settings, immunohistochemical analyses of p57KIP2 , an imprinted gene product, are widely used to differentiate CHMs from other conceptuses, including PHMs. Recently, new molecular genetic techniques, such as single nucleotide polymorphism arrays, have been applied to research on hydatidiform moles. In addition to insights from classical methods, such as chromosome analysis, recently developed approaches have yielded novel findings related to the mechanism underlying the development of androgenetic CHMs.
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Affiliation(s)
- Hirokazu Usui
- Department of Reproductive Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
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Bradshaw AW, Nikmehr B, Halicigil C, Stogner-Underwood K, Sadri-Ardekani H. Optimum identification of round spermatid in men with non-obstructive azoospermia: A commentary. Andrology 2021; 9:1817-1818. [PMID: 34618410 DOI: 10.1111/andr.13113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/01/2021] [Accepted: 09/26/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Aaron William Bradshaw
- Department of Urology, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.,Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Banafsheh Nikmehr
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.,Carolinas Fertility Institute, Winston-Salem, North Carolina, USA
| | - Cihan Halicigil
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Kimberly Stogner-Underwood
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.,Department of Pathology, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Hooman Sadri-Ardekani
- Department of Urology, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.,Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.,Department of Pathology, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
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Wenk RE, Peterson J, Baird M. A molecular classification of moles and its use in filiation tests. J Forensic Sci 2021; 67:328-331. [PMID: 34596233 DOI: 10.1111/1556-4029.14890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/09/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022]
Abstract
Pregnancies, including ones that follow sexual assaults, occasionally produce hydatidiform moles. The alleged fathers (AFs) of moles have been tested for paternity by identifying the mole's locus phenotype-the one or two visible paternal obligate alleles (POAs) per locus. The probability that the mole inherited the POAs from the AF was divided by the probability that the mole inherited the POAs from a random man. This likelihood ratio (LR) would increase if the mole's specific genotype was known. Moles are generated in five different ways that produce five distinct genotypes. Examining a mole's multilocus STR profile reveals a mole's pathogenesis, determines locus genotypes, and increases paternity LRs.
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Affiliation(s)
- Robert E Wenk
- Forensics Division, DNA Diagnostics Corporation, Fairfield, Ohio, USA
| | - John Peterson
- Forensics Division, DNA Diagnostics Corporation, Fairfield, Ohio, USA
| | - Michael Baird
- Forensics Division, DNA Diagnostics Corporation, Fairfield, Ohio, USA
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