Diagnostic Value of Lectins in Differentiation of Molar Placentas

Document Type : Original Article

Authors

1 Department of Anatomy and Cell Biology, Mashhad University of Medical Science, Mashhad, Iran

2 Department of Pathology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Anatomy and Cell Biology, Mashhad University of Medical Sciences, Mashhad, Iran

4 Immunology Research Centre, BuAli Research Institue, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Medical Ethics, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Objective(s)
Distinction of hydatidiform moles from non-molar specimens and subclassification of hydatidiform moles as complete and partial are important for clinical practice, but diagnosis based solely on histomorphology suffers from poor interobserver reproducibility. Nowadays, pathologists rely on molecular techniques, however these methods are technically difficult, relatively expensive, and time consuming, and cannot be applied in all laboratories. Therefore, a relatively easy, time- and cost-effective ancillary tool, would be helpful. This study aimed to assess the role of lectins in differential diagnosis of molar placentas.
Materials and Methods
Lectin histochemistry with a panel of HRP-conjugated lectins comprising SBA, DBA, MPA, PNA, VVA, UEA-1, LTA, GS-І (B4), and WGA were performed in 20 non-molar (hydropic and non-hydropic spontaneous abortions) and 20 molar (partial and complete moles), formalin-fixed paraffin-embedded tissue samples. On the basis of staining intensity, sections were graded and Kruskal-Wallis non-parametric statistical test was used to compare differences between samples.
Results
There was a significant difference between the reactivities of LTA and UEA-І with syncytiotrophoblasts of molar and non-molar specimens (P<0.001). These lectins generally showed a moderate reactivity with syncytiotrophoblasts of molar group but did not react with this cell population in non-molar group. Furthermore, WGA showed relatively increased reaction with syncytiotrophoblasts of molar tissues compared with abortions, however, this did not reach to statistical significance (P=0.07). No major differences were seen in other lectins reactivities between the studied groups.
Conclusion
The present study showed that UEA-1 and LTA lectins may be used as cytochemical probes in differentiating molar from non-molar placentas, but did not differentiate partial moles from complete moles.

Keywords


1. Soper JT, Mutch DG, Schink JC and American College of Obstetricians and Gynecologists. Diagnosis and treatment of gestational trophoblastic disease. ACOG Practice Bulletin No. 53. Gynecol Oncol 2004 Jun; 93(3): 575–585.
2. Berkowitz RS, Goldstein DP. Diagnosis and management of primary hydatidiform mole Obstet Gynecol. Clin. North Am 1988; 15:491–503.
3. Soper JT. Gestational trophoblastic disease. Obstet Gynecol 2006; 108:176-187.
4. Howat AJ, Beck S, Fox H et al. Can Histopathologists Reliably Diagnose Molar Malignancy? J Clin Pathol 1993; 46: 599-60.
5. Fukunaga M,Katabuchi H,Nagasaka T,et al .Interobserver and intraobserver variability in the diagnosis of hydatidiform mole, Am J Surg Pathol 2005;29:942-947.
6. Crips H, Burton JL, Stewart R, Wells M. Refining the diagnosis of hydatidiform mole: image ploidy analysis and p57KIP2 immunohistochemistry. Histopathology 2003; 43:363–373.
7. Walker RA. The use of lectins in histopathology. Pathol Res Pract 1989; 185:826-35.
8. Pilobello K, Mahal LK..Lectin microarrays for glycoprotein analysis. Methods Mol Biol 2007; 385:193-203.
9. Fazel AR, Schulte BA, Spicer SS.Glycoconjugate unique to migrating primordial germ cell differs with Genera.Anat Rec 1990; 228:177-184.
10. Fazel AR, Thompson R.P, Shumida H, Shulte BA Lectin histochemistry of the embryonic heart: expression of terminal and penultimate galactose residues in developing rats and chicks. Am J Anat 1989;184:85-94.
11. Ebrahimzadeh Bideskan AR, Hassanzadeh Taheri MM, Nikravesh MR, Fazel AR. Lectin histochemical study of vasculogenesis during rat pituitary morphogenesis. Iran J Basic Med Sci Jan-Feb 2011;14(1):35-41.
12. Nasir E, Lalani M, Bulmer JN, Wells M. Peroxidase-labeled lectin binding of human extravillous trophoblast. Placenta 1987;8:15-26.
13. Cooper HS. Peanut lectin binding sites in large bowel carcinoma.Laboratory investigations 1982;47:383-388.
14. Itzkowitz S H, Yuan M, Montgomery C K, Kjeldsen T, Takahashu H K, Bigbee W L. Expression of Tn, sialosyl-Tn and T antigen in human colon cancer. Cancer Res 1989;49:197-204.
15. Silva F G, Nadasdy T, AND Laszik Z. Immunohistochemical and lectin dissection of the human nephron in health and disease. Arch Pathol Lab Med 1993; 117:1233-1239.
16. Juan FT, Hoshina AM, Mochizuki M. Lectin binding in tissues from hydatidiform mole, invasive mole and choriocarcinoma to cancavalin A, wheat germ agglutinin and peanut agglutinin.Asia Oceania J Obstet Gynecol 1989 Dec;15(4):383-93.
17. Sgambatia E, Biagiotti R, Marini M and Brizzi E. Lectin histochemistry in the human placenta of pregnancies complicated by intrauterine growth retardation based on absent or reversed diastolic flow. Placenta 2002; 23:503–515.
18. Bancroft JD, Gamble M. Theory and Practice of histological techniques. 7th ed. London: Churchhill Livingstone; 2008.
19. Lee MC and Damjanov I Lectin histochemistry of human placenta. Differentiation 1984; 28: 123–128.
20. Jones CJP, Dantzer V, Leiser R and Krebs C. Localisation of glycans in the placenta: a comparative study of epitheliochorial, endotheliochorial, and haemomonochorial placentation. Micr Res Techn, 1997; 38: 100–114.
21. Tatsuzuki A, Ezaki T, Makino Y, Matsuda Y, Otha H. Characterization of the sugar chain expression of normal term human placental villi using lectin histochemistry combined with immunohistochemistry. Arch Histol Cytol 2009; 72(1):35-49.
22. Goldstein IJ and Poretz RD. Isolation, physicochemical characterization and carbohydrate-binding specificity of lectins. In The lectins, properties, functions and application in biology and medicine (Eds) Lierner IE, Sharon Nand Goldstain IJ London: Academic Press 1986; pp. 35–347.
23. Schulte BA and Spicer SS. Histochemical evaluation of mouse and rat kidneys with lectin horseradish peroxidase conjugates. Am J Anat 1983; 168: 345–362.
24. Whyte A. Lectin binding by microvillous membranes and coated-pit regions of human syncytial trophoblast. Histochem J 1980; 12: 599–607.
25. Jones CJP, Dantzer V, Leiser R and Krebs C. Localisation of glycans in the placenta: a comparative study of epitheliochorial, endotheliochorial, and haemomonochorial placentation. Micr Res Techn 1997; 38: 100–114.
26. Truman P,Ford HC.The brush border of the Human term placenta. Biochimica et Biophysica Acta 1984;779:139-160.
27. Lang I, Hartmann M, Blaschitz A, Dohr G, Skofitsch G and Desoye. Immunohistochemical evidence for the heterogeneity of maternal and fetal vascular endothelial cells in human full-term placenta. Cell Tissue Res 1993; 274:211–218.
28. Thrower S, Bulmer JN, Griffin NR and Wells M. Further studies of lectin binding by villous and extravillous trophoblast in normal and pathological pregnancy. Int J Gynecol Pathol 1991; 10: 238–251.
29. Jeffrey IJM, Mosley SJ, Jones CJP, Stoddart RW.Proteolysis and lectin histochemistry. Histochem J 1987;19:269-75.
30. Sgambati E, Marini M, Vichi D, Zappoli G, Parretti E, Mello G, Gheri G. Distribution of the glycoconjugate oligosaccharides in the human placenta from pregnancies complicated by altered glycemia: lectin histochemistry. Histochem Cell Biol 2007; 128:263–273.
31.Richter DU, Jeschke U, Makovitzky J, Goletz S, Karsten U, Briese V, et al. Expression of the Thomsen–Friedenreich (TF) antigen in the human placenta. Anticancer Res. 2000; 20:5129-5133.