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We get a few POCs per week, and of those a small percentage have morphologic changes that put them in the "cannot rule out a partial mole" category. These get sent out for molecular testing, which takes a long time to result. The May issue of AJCP had an interesting article "Diagnostic utility of Twist1, Ki-67, and E-cadherin in diagnosing molar gestations and hydropic abortions." by Rabab A. Moussa et al.
In it, the authors purported across the board 100% sensitivity, specificity, PPV and NPV using Twist1 IHC. Which is great, but adding Twist1 to our IHC menu to solve this problem may not be efficient.
We already have Ki-67 and e-cadherin in use, however, and the study reports that those do a good job in partial moles vs. hydropic abortions. The application is a bit fiddly, however, as you have to semi-quantitatively assess the percentage and strength of expression of the two stains, respectively. I.e. High Ki-67 % and low e-cadherin: partial mole, low Ki-67 and high e-cadherin: hydropic abortion.
Is anyone out there using this approach?
In it, the authors purported across the board 100% sensitivity, specificity, PPV and NPV using Twist1 IHC. Which is great, but adding Twist1 to our IHC menu to solve this problem may not be efficient.
We already have Ki-67 and e-cadherin in use, however, and the study reports that those do a good job in partial moles vs. hydropic abortions. The application is a bit fiddly, however, as you have to semi-quantitatively assess the percentage and strength of expression of the two stains, respectively. I.e. High Ki-67 % and low e-cadherin: partial mole, low Ki-67 and high e-cadherin: hydropic abortion.
Is anyone out there using this approach?