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Can immunohistochemistry improve the pathological diagnosis of placenta accreta spectrum (PAS) disorders?
Losi, Lorena; Botticelli, Laura; Mancini, Luciano; Negro, Rosa; Hanspeter, Esther; Dematté, Eva; Grandi, Giovanni; Facchinetti, Fabio; Veneziano, Micaela; Malagoli, Claudia; Masini, Meris; Fabbiani, Luca; Rivasi, Francesco.
Afiliación
  • Losi L; Department of Life Sciences, Unit of Pathology, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy. lorena.losi@unimore.it.
  • Botticelli L; Unit of Pathology, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy.
  • Mancini L; Unit of Pathology, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy.
  • Negro R; Service of Pathology of Azienda Ospedaliera of Bolzano, Bolzano, Italy.
  • Hanspeter E; Service of Pathology of Azienda Ospedaliera of Bolzano, Bolzano, Italy.
  • Dematté E; Service of Pathology of Azienda Ospedaliera of Bolzano, Bolzano, Italy.
  • Grandi G; Department of Medical and Surgical Sciences for Mother, Child and Adult, Obstetrics and Gynecology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy.
  • Facchinetti F; Department of Medical and Surgical Sciences for Mother, Child and Adult, Obstetrics and Gynecology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy.
  • Veneziano M; Obstetrics and Gynecology Unit, Bolzano Hospital, Bolzano, Italy.
  • Malagoli C; Unit of Pathology, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy.
  • Masini M; Department of Medical and Surgical Sciences for Mother, Child and Adult, Obstetrics and Gynecology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy.
  • Fabbiani L; Department of Medical and Surgical Sciences for Mother, Child and Adult, Unit of Pathology, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy.
  • Rivasi F; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Arch Gynecol Obstet ; 2023 Aug 03.
Article en En | MEDLINE | ID: mdl-37535133
PURPOSE: The term of placenta accreta spectrum (PAS) disorder includes all grades of abnormal placentation. It is crucial for pathologist provide standardized diagnostic assessment to evaluate the outcome of management strategies. Moreover, a correct and safe diagnosis is useful in the medico-legal field when it becomes difficult for the gynecologist to demonstrate the suitability and legitimacy of demolitive treatment. The purposes of our study were: (1) to assess histopathologic features according to the recent guidelines; (2) to determine if immunohistochemistry can be useful to identify extravillous trophoblast (EVT) and to measure the depth of infiltration into the myometrium to improve the diagnosis of PAS. METHODS: The retrospective study was conducted on 30 cases of gravid hysterectomy with histopathologic diagnosis of PAS. To identify the depth of EVT, immunohistochemical stainings were performed using anti MNF116 (cytokeratins 5, 6, 8, 17, 19), actin-SM, HPL (Human Placental Lactogen), vimentin and GATA3 antibodies. RESULTS: Our cases were graded based on the degree of invasion of the myometrium. Ten were grade 1 (33.3%), 12 grade 2 (40%) and 8 grade 3A (26.7%). EVT invasion was best seen and evident by double immunostainings with actin-SM and cytokeratins, actin-SM and HPL, actin-SM and GATA3. CONCLUSION: The role of pathologist is decisive to determine the different grades of PAS. A better understanding of the depth of myometrial invasion can be achieved by the use of immunohistochemistry affording an important tool to obtain reproducible grading of PAS. This purpose is crucial in the setting of postoperative quality reviews and particularly in the forensic medicine field.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies Idioma: En Revista: Arch Gynecol Obstet Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies Idioma: En Revista: Arch Gynecol Obstet Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania