Immunohistochemical staining for diagnosis and prognostic assessment of hydatidiform moles: current evidence and future directions.

OBJECTIVE: To review the published data on studies examining immunohistochemical markers of hydatidiform moles for determination of diagnosis or prognosis, with regard to whether such investigations can provide clinically relevant information. STUDY
DESIGN: Search of computerized literature databases to identify studies reporting on immunohistochemical findings in cases of hydatidiform mole followed by summarization and interpretation of the findings.
RESULTS: Of 166 studies initially identified, 88 studies were included in the final analysis. Some markers, such as P57(KIP2), show distinct differences in expression between groups and are useful in clinical practice for the diagnosis of complete hydatidiform moles. Some markers appear to be associated with increased risk of progression to requiring chemotherapy, including increased expression of P53, EGFR, HER2, c-erbB-2 and telomerase and reduced expression of nm23.
CONCLUSION: Despite technical issues complicating overall interpretation, such as small sample size and the uncertainty of classification of hydatidiform moles in many studies, convincing data is reported for several markers, which should guide future studies. Insufficient data exists to recommend changes in clinical management based on current evidence.