Background: A diverse range of conditions linked to an abnormal trophoblast growth are collectively known as gestational trophoblastic disease (GTD), which are classified into: tumor-like lesions, molar pregnancies and gestational trophoblastic neoplasms.
Aim of the work: to study Immunohistochemical expression of VEGF, BCL-2, p63 and serum β‑hCG in hydropic abortion, molar pregnancy & choriocarcinoma to elucidate their role in pathogenesis and diagnosis in these entities.
Material & Methods: This retrospective Immunohistochemical study of VEGF, BCL-2, p63 & serum β‑hCG was carried upon 65 selected cases of gestational trophoblastic diseases.
Results: VEGF was increased gradually from hydropic abortion, molar pregnancy to choriocarcinoma (P=0.000). While BCL-2 and p63 were downregulated markedly from hydropic abortion to be weakly or negatively expressed of choriocarcinoma cases (p=0.000). Serum β‑hCG also increased in the same pattern as VEGF (P =0.000). BCL-2 & p63 and β‑hCG are more sensitive (100% & 90% & 100%) and specific (56.4%, 100%, 99%, respectively) in diagnosis of choriocarcinoma. BCL-2 & p63 were highly sensitive markers (81.8% & 100%) in differentiating hydropic abortion from molar pregnancy.
Conclusion: VEGF, BCL-2, p63 expression and elevated serum β‑hCG level might have role in gestational trophoblastic disease pathogenesis and progression. Combined expression of BCl-2, p63 and high β‑hCG, might be useful to differentiate choriocarcinoma from other gestational trophoblastic diseases and hence target therapy. BCl-2, p63 could be used as markers for early diagnosis of molar pregnancy.