Scott A Shainker1,2, Katelyn Dannheim3,4, Kristin D Gerson2,5, Dayna Neo6, Zsuzsanna K Zsengeller7,8, Elizabeth Pernicone9, S Ananth Karumanchi1,10, Michele R Hacker1,6, Jonathan L Hecht11,12. 1. Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, USA. 2. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. 3. Clinical Fellow of Pathology, Harvard Medical School, Boston, USA. 4. Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. 5. Clinical Fellow of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, USA. 6. Program in Epidemiologic Research, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. 7. Medicine, Harvard Medical School, Boston, USA. 8. Department of Molecular Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. 9. Department of Molecular Medicine, Beth Israel Deaconess Medical Center, 99 Brookline Ave. Room # 359, Boston, MA, 02115, USA. 10. Division of Nephrology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. 11. Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, USA. jhecht@bidmc.harvard.edu. 12. Gynecologic and Placental Pathology, Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. jhecht@bidmc.harvard.edu.
Abstract
PURPOSE: To confirm reduced expression of soluble fms-like tyrosine kinase 1 (sFlt-1) in accreta/increta. METHODS: Formalin-fixed tissue sections from 11 peripartum hysterectomies with invasive placentation and 5 controls were stained for sFlt-1. Stain intensity was scored in selected 100× microscopic fields. We compared sFlt-1 expression in invasive areas among cases, non-invasive areas among cases and areas from control placentas. RESULTS: Chorionic villi displayed significantly decreased sFlt-1 expression in invasive areas of cases compared to control placentas (p = 0.003), as well as in non-invasive areas of cases compared to control placentas (p = 0.01). There was no difference in sFlt-1 expression between invasive and non-invasive areas among cases. CONCLUSIONS: Expression of sFlt-1 is diminished in villous trophoblasts from patients with placenta increta or percreta. Local depth of invasion was not associated with sFlt-1 expression, suggesting a more global abnormality across the implantation site rather than localized to areas of histologic invasion.
PURPOSE: To confirm reduced expression of soluble fms-like tyrosine kinase 1 (sFlt-1) in accreta/increta. METHODS:Formalin-fixed tissue sections from 11 peripartum hysterectomies with invasive placentation and 5 controls were stained for sFlt-1. Stain intensity was scored in selected 100× microscopic fields. We compared sFlt-1 expression in invasive areas among cases, non-invasive areas among cases and areas from control placentas. RESULTS: Chorionic villi displayed significantly decreased sFlt-1 expression in invasive areas of cases compared to control placentas (p = 0.003), as well as in non-invasive areas of cases compared to control placentas (p = 0.01). There was no difference in sFlt-1 expression between invasive and non-invasive areas among cases. CONCLUSIONS: Expression of sFlt-1 is diminished in villous trophoblasts from patients with placenta increta or percreta. Local depth of invasion was not associated with sFlt-1 expression, suggesting a more global abnormality across the implantation site rather than localized to areas of histologic invasion.