Objective: The purpose of our study was to assess trophoblastic and uterine sufficiency in miscarriage pathogenesis with immunohistochemical methods and to determine if they could be used as a screening tool for the risk of miscarriage in the future. Material and Method: Placental tissue specimens that were comprised of 20 spontaneous abortions, 23 voluntarily terminated (induced) abortions, and 12 tubal pregnancies were included in this study. Trophoblastic cells and implantation area were evaluated for staining with EGFR-1, MMP-3, and MMP-9 by immunohistochemistry. Results: EGFR-1 expression was more intense and diffuse in decidual cells in the placental bed of spontaneous abortion specimens; this difference was statistically significant (P=0.004). MMP-3 expression was markedly increased in villous and extravillous trophoblastic cells in induced abortions; the difference between the groups was found to be statistically significant (P values ranged from < 0.01 to 0.005). MMP-9 expression tended to be higher in spontaneous abortion and tubal pregnancy specimens, and the results were statistically significant as P values were lower than 0.01. Conclusion: Higher EGFR-1 expression in the decidual tissue of spontaneous abortion specimens suggests that EGFR-1 triggers the migration of extravillous trophoblasts, leading to their destructive invasion. Similarly, MMP-9 immunopositivity might be indicative of aggressive invasion contributing to spontaneous abortion pathogenesis. Relatively high levels of MMP-3 expression in induced abortion specimens used as a control group might be a predictor of successful implantation, whereas its decreased expression might be indicative of risk for pregnancy loss.

The nested variant of transitional cell carcinoma is extremely rare in the bladder. Here we reported a new case and review the literature.

Objective: In this study, we investigated expressions of immunohistochemical markers P63, P27, P57, Ki-67, and CD146, in hydropic and molar specimens, to explore their role in pathogenesis of molar gestations. Design and Setting: Retrospective study. Methods: We enrolled 37 patients with a definitive pathologic diagnosis of HA (n = 10), PHM (n = 17), and CHM (n = 10). We scored immunoreactivity using antibodies against P63, P27, P57, Ki-67, and CD146 by evaluating the percentage of distinctly stained cells. Results.Compared to PHM and HA patients, CHM patients had severe cytologic atypia in CD146-positive extravillous trophoblastic column (TC) and florid syncytiotrophoblast (ST) proliferation. P57 immunostaining was negative in all but one of the CHM patients, whereas all HA and PHM patients showed positive immunostaining. PHM and HA patients also showed P63 and Ki-67 overexpression in cytotrophoblasts (CTs) compared to CHM patients. P27 was expressed in differentiated, nondividing syncytiotrophoblasts but did not yield any diagnostic aid. Conclusion: The proliferative activity location varied between molar and nonmolar pregnancies. PHM and HA patients have more progenitor cells, which express the highest levels of P63 compared to CHM patients. The loss of endogenous P63 expression in CHM cases may result in up-regulated genes, associated with invasion and metastasis, predisposing the body to a loss of epithelial and acquisition of mesenchymal characteristics.P63 deficiency, like P57 deficiency, induces exaggerated proliferation and differentiation and could be used as an ancillary diagnostic tool for CHM diagnosis. Keyword: Hydatidiform mole, hydropic abortion, p63, p27, p57, Ki-67, CD146. Continuous...

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