Refining the diagnosis of complete and partial moles: Role of p57 immunostaining in a tertiary care setting
DOI:
https://doi.org/10.55629/pakjpathol.v37i2.1014Keywords:
Hydatidiform Mole, Complete Hydatidiform Mole, Partial Hydatidiform Mole, p57 Protein, ImmunohistochemistryAbstract
Objective: To assess the utility of p57 immunohistochemistry to enhance the diagnostic accuracy of histopathology in differentiating complete and partial hydatidiform moles.
Material and Methods: An ambispective cross-sectional diagnostic utility study was conducted at the PNS Shifa Hospital, Karachi, and the Karachi Institute of Medical Sciences. A total of 54 hydatidiform mole cases collected between 1st April 2021 and 30th March 2026 were included. Initial diagnoses were based on histomorphological assessment of Hematoxylin and eosin (H&E)-stained sections, followed by p57 immunohistochemistry (IHC) for final classification as complete or partial hydatidiform mole. Associations between histomorphological features and mole type were analyzed using Chi-square test or Fisher’s exact test. Agreement between initial histomorphological and final p57-based diagnoses was assessed using Cohen’s kappa coefficient. Statistical analysis was performed using SPSS version 26.
Results: Histomorphological assessment demonstrated significant differences between complete and partial hydatidiform moles across the evaluated morphological features (p<0.05). Initially 35(64.8%) cases were classified as complete hydatidiform mole (CHM), and 19(35.1%) as partial hydatidiform mole (PHM). There was substantial agreement between the initial histomorphological and final p57-based diagnoses (κ =0.750, p<0.001). Following p57 immunohistochemistry, six discordant cases were reclassified, yielding final diagnoses of 37(68.5%) CHMs and 17 (31.5%) PHMs.
Conclusion: p57 immunohistochemistry provides a reliable and practical adjunct to histomorphology, improving diagnostic accuracy and supporting appropriate clinical management of hydatidiform moles.
Keywords: Complete hydatidiform mole, Hydatidiform mole, Immunohistochemistry, Partial hydatidiform mole, p57 Protein.
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