Expression patterns of maspin and mutant p53 are associated with the development of gestational trophoblastic neoplasia

Abstract

Gestational trophoblastic disease (GTD) is a group of conditions that originate from the abnormal proliferation of trophoblastic cells. GTDs encompass hydatidiform moles (HMs) and gestational trophoblastic neoplasia (GTN). GTNs are a group of malignant diseases that require chemotherapy, or more aggressive treatment. There is a requirement for more tumor markers to predict the development of GTN from HMs. The current study evaluated the expression of maspin and tumor protein p53 (p53) in GTD, and their role in predicting the development of GTN. Expression of maspin and mutant p53 (m-p53) was detected by immunohistochemistry in 48 normal first trimester placentas, matched for gestational age to 49 HMs that regressed, 39 malignant HMs and 11 invasive moles or choriocarcinomas. Spearman's rank correlation analysis and logistic regression were performed on the expression patterns of maspin and m-p53, and on the clinical prognostic factors in GTD. Compared with normal placenta levels, the expression levels of maspin were decreased, whereas the expression levels of m-p53 were increased in GTDs (P<0.05). The expression levels of maspin and m-p53 in complete and partial HMs were not significantly different (P>0.05). In HMs, maspin expression was inversely correlated with serum β human chorionic gonadotropin, uterine size and diameter of theca-lutein cysts; however, m-p53 expression demonstrated a positive correlation with these factors (all P<0.05). Compared with the high-risk metastatic group (FIGO score ≥7), the low-risk group (FIGO score <7) exhibited a higher rate of positive maspin expression (P=0.041), and the frequency of positive m-p53 expression was significantly higher in patients with an advanced FIGO stages (FIGO stage ≥III) compared with patients in early stages (FIGO stage ≤II; 87.9 vs. 58.8%; P=0.019). The combination of maspin negative expression with m-p53 positive expression had an 84% specificity value, 76% positive predictive value and 70% negative predictive value for the development of GTN. In conclusion, maspin-negative and m-p53-positive expression is associated with the development of GTN in HMs.

Management and prognostic analysis of patients with gestational trophoblastic neoplasia (GTN) in FIGO stage IV and its special type

“…As our data showed, two choriocarcinoma complicated with ETT were negative in the expression of SALL4. Pengming Sun et al [ 20 ] reported that the expression levels of mutant P53 were increased with the development of GTN. The information in our study likewise indicated that patients with P53 positivity had worse outcomes than its negative expression.…”

Wunderlich’s syndrome in a young man of testicular mixed germ cell tumor with choriocarcinoma syndrome

“…A genetic role, such as maspin-negative and mutant p53positive expression, is certain in the epidemiology of hydatid form mole, and complete moles appear to have the high risk of subsequent choriocarcinoma and metastasis [11]. In hydatid form mole, serum β-HCG is inversely correlated with maspin expression but is positively correlated with mutant p53 expression [12]. Trophoblast invasion is mediated through the major mediators of implantation, including the matrix metalloproteinase and epidermal growth factor, which transcription is mediated by positive p53 expression [13].…”

Evaluation of TP53 and HER-2/neu Genes Expression Levels in Gestational Trophoblastic Diseases Cases and Determining Their Predictive Value in Diagnosis of Malignancy and Disease Progression

“…Several attempts have already been developed for early diagnosis and differentiation of GTD different pathologies and the result is promising regarding immunohistochemical methods. According to previous studies, several biomarkers like P53, P57, P63, C-erB-2 (7-10), and maspin (11) have been investigated for such purposes and it has been shown that there was a strong association between P53 and C-erbB-2 expression and tro-phoblastic neoplasia (8). It was also illustrated that these two biomarkers together had high negative predictive values regarding the management of molar pregnancies (8).…”