KI67 IMMUNOSTAINING'S DIAGNOSTIC AND PROGNOSTIC SIGNIFICANCE IN GESTATIONAL TROPHOBLASTIC DISORDERS: A RETROSPECTIVE STUDY.

JPUMHS;2024:14:04,50-59.http://doi.org/10.46536/jpumhs/2024/14.04.560

Abstract

ABSTRACT:
BACKGROUND: Gestational trophoblastic diseases GTDs are rare gynecological disorders
caused by abnormal trophoblastic progression. Subtypes include complete moles,
partial moles, and hydropic abortions frequently share physical characteristics, challenging
diagnosis. Ki67, a nuclear proliferation marker, has emerged as a viable tool for improving
diagnostic accuracy and determining prognosis. OBJECTIVE: The aim of this study is to
examine the diagnostic and prognostic impact of Ki67 immunostaining for classifying GTD
subtypes and predicting high-risk patients, such as persistent trophoblastic disease PTD and
choriocarcinoma. METHODOLOGY: A retrospective descriptive study was carried out
from January to December 2023 in Lady Reading Hospital, Peshawar. In terms of
1,012 placental biopsy samples, 197 19.5% were diagnosed with GTDs, comprising 150
complete moles, 45 partial moles, and two unusual cases of choriocarcinoma and enhanced
placental site reactivity. Fifty cases were chosen for Ki67 immunostaining. Staining intensity
0 to 3+ and extent 0 to 4+ were evaluated and classified, and statistical analyses were done to
link findings to clinical outcomes. RESULTS: In 85% of cases complete moles revealed high
3+ Ki67 staining, with 70% showing a diffuse >50% extent. Partial moles showed moderate
2+ staining in 33.3% cases. However, hydropic abortions were primarily negative. All PTD
and choriocarcinoma cases had significant and diffused Ki67 staining. CONCLUSION:
Ki67 immunostaining is an effective technique for distinguishing GTD subtypes and
detecting high-risk cases. Its integration into standard diagnostic techniques, combined with
supporting markers, has the potential to improve GTD management, particularly in resource
constrained settings.