A Study on the Diagnostic Value of p57kip2 among Gestational Trophoblastic Diseases at a Philippine Hospital in 2020

Abstract

Hydatidiform mole (H. mole), a gestational trophoblastic disease, is common in the Philippines. In general, the differentiation between complete hydatidiform mole and partial hydatidiform mole is based on morphologic evaluation via routine H&E. The problem lies on the lack of a standard criteria and overlapping features. The p57kip2 immunohistochemical stain is inexpensive, locally available, and could provide reliable results in differentiating between complete H. mole and partial H. mole.  This study aims to determine the accuracy of the diagnosis of H. moles by routine H&E stain as compared to the diagnosis by p57kip2 IHC stain. There were a total of 31 cases of H. moles in 2020. It includes 20 cases of complete H. moles and 11 cases of partial H. moles. With the advent of the p57kip2 IHC stain, a total of 18 cases were diagnosed as complete H. mole and 13 were diagnosed as partial H. mole. Diagnostic statistics such as sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), accuracy, and kappa statistics were computed to validate the diagnostic value of H&E staining with p57kip2 IHC staining on H. moles. This study concludes that a significant increase in accuracy and reliability are attained when supplemented with p57kip2 IHC stain. In addition, criteria in analyzing p57kip2 are simple and reproducible without significant interobserver variability. It is therefore recommended to use p57kip2 IHC stain on vesicular tissues to deduce the true nature of their pathology.