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Results for “Hydatidiform Mole, Invasive”

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At least 19 recordsLinked to original sources
PubMed1993

Decreased expression of epidermal growth factor and its receptor in the malignant transformation of trophoblasts.

BACKGROUND: Gestational trophoblastic neoplasms comprise the neoplastic spectrum of nonmalignant hydatidiform mole, invasive hydatidiform mole, and truly malignant choriocarcinoma. Increasing evidence indicates that epidermal growth factor (EGF) acts as an enhancer of trophoblast function to produce human chorionic gonadotropin and that EGF and its receptor may provide a growth advantage to certain carcinoma cells. The current study was undertaken to evaluate a possible link between malignant transformation of trophoblast and expression of EGF and EGF receptor. METHODS: Cytologic localization and cellular levels of expression of EGF and EGF receptor in hydatidiform mole, invasive hydatidiform mole, and choriocarcinoma tissue specimens were examined by the avidin-biotin immunoperoxidase techniques with monoclonal antibodies against EGF and EGF receptor. RESULTS: EGF in hydatidiform mole and invasive mole was localized in syncytiotrophoblasts, whereas cytologic localization of EGF receptor in hydatidiform mole and invasive mole was observed in both cytotrophoblasts and syncytiotrophoblasts. By contrast, EGF and EGF receptor in choriocarcinoma were exhibited in cytotrophoblastic and syncytiotrophoblastic elements. Most (72%) hydatidiform moles immunostained intensely for EGF and EGF receptor, whereas most (78%) choriocarcinomas immunostained slightly for EGF and EGF receptor. Invasive mole occupied the middle position in the staining intensity for EGF and EGF receptor, between hydatidiform mole and choriocarcinoma, with 50% of the cases exhibiting moderate staining. CONCLUSIONS: The simultaneous expression of EGF and EGF receptor in the neoplastic trophoblasts implies that EGF may act in an autocrine-paracrine manner in trophoblastic neoplasms. Furthermore, the results obtained suggest that cytologic expression of EGF and EGF receptor in trophoblastic neoplasms decreases in the malignant transformation of trophoblast.

Cell Transformation, Neoplastic↗
PubMed1987

Clinical problems of invasive hydatidiform mole in patients aged 40 or more.

Seventy-six patients with invasive hydatidiform mole (HM) were reviewed as to clinical course, particularly treatment and outcome, in relation to their age. The results were as follows: (i) metastatic cases showed approximately a twofold increase in patients over 40 compared with younger patients, (ii) more courses of chemotherapy were required to achieve a cure in patients over 40 than in younger patients and (iii) 4 of 19 patients (21.1%) over 40 developed choriocarcinoma, whereas none of younger patients did.

Adult↗
PubMed1993

[Clinical evaluation of ultrasonography in diagnosis of the early invasive hydatidiform mole].

The consecutive uterine changes of the B ultrasonic scan were observed in 41 cases with invasive hydatidiform mole, which compared with the uterine changes in 10 controls who had induction of labor in second trimester. It was found that B ultrasonic scan was very useful technic in diagnosis of invasive mole. The time when the serum hCG titers fell to normal was earlier than the time of B scan reversed during treatment. Therefore, the B scan of uterus is of value in early diagnosis and therapeutic quide of invasive mole.

Adult↗
PubMed2004

Ultrasound-guided local injection of methotrexate to treat an invasive hydatidiform mole.

A 28-year-old Japanese woman had an invasive hydatidiform mole which was diagnosed by means of transvaginal ultrasonography. After the two initial courses of systemic methotrexate (MTX) therapy given over a period of weeks, the tumor was 14 mm in diameter and the surrounding blood supply remained rich. In addition to the two initial courses of systemic MTX therapy, local ultrasound-guided injection of MTX therapy was given three times, once per week. After the local MTX treatment, the betahCG level, which had been as high as 240 ng/mL, dropped to less than 0.1 ng/mL. We then gave two additional courses of systemic MTX therapy (once per week). More than 3 years have passed since the final systemic MTX therapy, and the patient's serum betahCG levels continue to be less than 0.1 ng/mL. An invasive mole can be treated with an ultrasound-guided local injection of MTX in addition to the established systemic MTX treatment.

Abortifacient Agents, Nonsteroidal↗
PubMed2005

A case of metastasizing invasive hydatidiform mole. Is less--less good? Review of the literature with regard to adequate treatment.

BACKGROUND: Patients with invasive hydatidiform moles (IHM) have a good prognosis. Even if disease has spread, monocytostatic treatment might be sufficient if the diagnosis has been histologically confirmed. Established classifications divide gestational trophoblastic disease (GTD) including choriocarcinoma into cases with "high" and "low" risk. Without respect to histology "high-risk" cases are recommended to obtain polychemotherapy. CASE: A 40-year-old nullipara underwent hysterectomy for persistent vaginal bleeding after she had already been treated with curettage for hydatidiform mole. An IHM was pathohistologically confirmed. There were no signs of pulmonary spread or other metastases at the time of surgery. Postsurgically persistent beta-hCG levels lead to thorough staging, which revealed multiple pulmonary metastases and a vaginal metastasis. Despite metastasizing GTD with poor prognosis criteria she was treated with single agent therapy. Eight cycles of two weekly methotrexate (MTX) were administered. All sites of metastases responded and our patient is still fine after one year of follow-up. CONCLUSION: With respect to this and other reports monochemotherapy can be a reasonable primary treatment for metastatic IHM.

Adult↗
PubMed1984

[The determination of the recognition site of an antiserum detecting desialylation on O-glycosidic carbohydrates of hCG and its clinical applications. The relationship between the presence of asialo-hCG and malignant change in trophoblastic disease].

Human chorionic gonadotropin (hCG) is a specific tumor marker glycoprotein hormone for trophoblastic diseases. It contains 4 asparagine-linked and 4 serine-linked carbohydrate units. Recently, variations in the carbohydrate moieties of hCG in chorio-carcinoma have been suggested. However, the immunological method of detecting these malignant transformational changes of carbohydrate units in hCG have not been investigated. We therefore attempted to assess the possibility of establishing a radioimmunoassay system which can detect these transformational changes in serine-O-glycosidically linked carbohydrate units of hCG. HCG-specific hCG beta COOH-terminal portion contains all 4 O-glycosidically linked sugar chains (positions 121, 127, 132 and 138). An antiserum (R141) generated against the enzymatically cleaved, desialylated hCG beta COOH-terminal peptide (residue 123-145) by toepad immunization method was extensively characterized. This antiserum reacts with asialo-hCG better than with native hCG. It does not bind with synthetic COOH-terminal peptides nor monosaccharides such as N-acetyl-D-galactosamine and D-galactose, which are sugar components in O-glycosidic carbohydrate chains. The HF-treated asialo-hCG, in which galactose residues are further removed, still reacts with the antiserum. The antiserum requires both the peptide sequence and N-acetyl-D-galactosamine residues for its binding. Glycophorine and fetuin, which also contain the same O-glycosidic carbohydrate structure, do not react with the antiserum. Beta subunit gains its binding capability to the antiserum only upon desialylation, while native alpha and beta subunits do not react. The antiserum has high specificity toward asialo-hCG in which particularly O-glycosidic carbohydrate units are desialylated. With a specific radioimmunoassay system using this antiserum (R141), urinary hCG preparations from 29 patients with various trophoblastic diseases were analyzed. Asialo-hCG immunoactivity was insignificant in all patients with hydatidiform mole, invasive hydatidiform mole and persisted trophoblastic disease. However, asialo-hCG was found in 2 out of 6 cases of choriocarcinoma. The existence of asialo-hCG may be related to the advancement of disease.(ABSTRACT TRUNCATED AT 400 WORDS)

Asialoglycoproteins↗
PubMed1988

Clinical evaluation of focal excision of myometrial lesion for treatment of invasive hydatidiform mole.

To determine the clinical significance of conservative surgical therapy, namely focal excision of myometrial molar deposits, 22 patients with invasive hydatidiform mole (HM) who had received the therapy were analysed for their postoperative clinical course and reproductive performance. They were operated on because of their prolonged HCG regression curve and the presence of abnormal shadows in the uterine wall revealed by pelvic angiography, ultrasonography and computerized tomography after evacuation of intra-uterine molar tissue. A definitive diagnosis of invasive HM was established histopathologically in all of the extirpated materials. Seven of the patients were given postsurgical chemotherapy because of prolongation of their HCG decrease after the operation. The following items were emphasized as necessary criteria when selecting patients for surgery consisting in complete resection of the myometrial lesion: (1) urinary HCG titers below 10,000 IU/day; (2) no evidence of pulmonary metastatic involvement; or (3) metastases in the lungs, controlled with chemotherapy prior to the operation. Their reproductive performance was almost the same as that of comparable patients who were treated by chemotherapy alone.

Adult↗
PubMed1989

Lectin binding in tissues from hydatidiform mole, invasive mole and choriocarcinoma to concanavalin-A, wheat germ agglutinin and peanut agglutinin.

A light microscopic analysis of lectin receptors in normal placenta and trophoblastic disease was performed utilizing biotinylated Concanavalin-A (Con-A), wheat germ agglutinin (WGA), and peanut agglutinin (PNA), in conjunction with an avidin-biotin peroxidase complex. Hydatidiform mole, invasive mole and choriocarcinoma exhibited increased receptors to Con-A and WGA compared to normal placenta. Increased reactivity to Con-A and WGA was associated merely with increased growth and proliferation of trophoblasts rather than a malignant transformation. Normal placenta, partial and complete mole generally showed moderate to strong binding with PNA after neuraminidase treatment, while invasive mole and choriocarcinoma (11 of 15 cases) generally showed minimal to absent reaction with PNA. Heterogeneity of PNA binding in choriocarcinoma was manifested by the presence of PNA reactivity in the trophoblast membrane in 2 cases wherein no prior neuraminidase treatment was given. This suggests that in some malignant trophoblasts, there is absence of sialic acid in the terminal cell surface carbohydrate groups resulting in the exposure of N-acetylgalactoseamine.

Choriocarcinoma↗
PubMed2005

[Choriocarcinoma treatment: goal and issues].

The success of choriocarcinoma treatment in Japan is over 90% at the present time. As for the first contribution, chemotherapeutic progress contributed to this success greatly. The next contribution is establishment of the registration system of administration of the hydatidiform mole patients, since the course of choriocarcinoma in most cases is hydatidiform mole --> invasive mole --> choriocarcinoma. When treatment is begun by preventive measures for benign tumors at the very onset of the invasive hydatidiform mole, there are fewer choriocarcinoma onsets. Moreover, discovery of choriocarcinoma in the initial stages contributes to a better prognosis. However, following abortion or normal childbirth, different measures may be necessary. No problems were found with patients once treated for invasive hydatidiform mole in connection with current problems involving post-treatment pregnancy or delivery. However, in cases of pregnancy or abortion after choriocarcinoma treatment done with multi-cancer agents strongly, heart malformations are seen in some newborns, and how to preserve egg cells may pose a problem at the time of anti-cancer agent administration.

Choriocarcinoma↗
PubMed2001

Expressions of proliferation markers (Ki-67, proliferating cell nuclear antigen, and silver-staining nucleolar organizer regions) and of p53 tumor protein in gestational trophoblastic disease.

OBJECTIVE: This study was undertaken to determine whether the expressions of 3 proliferation markers (Ki-67, proliferating cell nuclear antigen, and silver-staining nucleolar organizer regions) and of p53 tumor protein could differentiate spontaneous abortions from gestational trophoblastic diseases and also discriminate among gestational trophoblastic disease subgroups. STUDY DESIGN: Twenty-two partial hydatidiform moles, 17 complete hydatidiform moles, 6 invasive hydatidiform moles, and 20 nonhydropic spontaneous abortions (control group) were evaluated by means of immunohistochemical techniques with antibodies to Ki-67, proliferating cell nuclear antigen, and p53. One-step silver staining was used to detect silver-staining nucleolar organizer regions. RESULTS: The expressions of Ki-67, proliferating cell nuclear antigen, silver-staining nucleolar organizer regions, and p53 were significantly higher in the gestational trophoblastic disease group than in the control group. The results of linear discriminant analysis showed that silver-staining nucleolar organizer region count had the highest sensitivity and specificity (93.3% and 100%, respectively) for distinguishing gestational trophoblastic disease from spontaneous abortion. Sensitivity and specificity for discriminating gestational trophoblastic disease from spontaneous abortion increased to 100% when all four markers were used together. Proliferating cell nuclear antigen was found to be the best discriminating variable for differentiating among gestational trophoblastic disease subgroups. CONCLUSION: Our findings suggest that expressions of Ki-67, proliferating cell nuclear antigen, silver-staining nucleolar organizer regions, and p53 may aid in the diagnosis of gestational trophoblastic diseases. These fairly rapid, simple, and economic techniques could serve as a useful adjunct to conventional methods in the diagnosis of gestational trophoblastic diseases.

Abortion, Spontaneous↗