Korean J Pathol.
1999 May;33(5):353-360.
Morphohistometric Investigation and bcl-2 Expression in the Placenta of Chromosomally Abnormal Pregnancy
- Affiliations
-
- 1Department of Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan University college of Medicine.
- 2Samsung Biomedical Research Institution, Clinical Research Center, Seoul 135-710, Korea.
- 3Department of Diagnostic Pathology, Asan Medical Center, College of Medicine, Ulsan Univerisity, Korea.
Abstract
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To evaluate the significance of placental histology, a collaborative histological and
cytogenetic study was performed on the products of 88 spontaneous abortions, and
subsequently bcl-2 immunostaining was performed on 62 cases. The morphometric
parameters included were DCIRCLE, FORMSHAPE, CPRATIO, and the expression of
bcl-2 immunostainig was graded in four categories (I to IV). The results were as
follows: 1) 40% (n=35) were chromosomally abnormal: trisomies predominated (57%,
n=20) and was followed by triploidy (14%, n=5), double trisomy (6%, n=2), monosomy X
(6%, n=2), inversion (9) (6%, n=2). 2) mean of DCIRCLE in chromosomally abnormal
pregnancy was 40 micrometer larger than that in chromosomally normal pregnancy (p=0.012,
one side t-test), while no difference was found in FORMSHAPE and CPRATIO between
chromosomally abnormal and normal pregnancy. 3) bcl-2 expression was found in
syncytiotrophoblast and cytotrophoblast. bcl-2 expression was weaker in chromosomally
abnormal pregnancy with intensity I and II of 59% than chromosomally normal
pregnancy with intensity I and II of 24%. 4) In comparison bcl-2 expression with
DCIRCLE, in chromosomally normal abortion one (10%) in I & II and one (3%) in III &
IV showed large DCIRCLE (above 360 micrometer), while 11 (85%) in I & II and 3 (33%) in
III & IV in chromosomally abnormal pregnancy. It would mean that bcl-2 protein is
necessary in preservation of pregnancy and placental morphology. Abnormal villous
diameter and weak bcl-2 expression may be suggestive of chromosomal anomaly.
Besides other histologic parameters, application of bcl-2 immunostaining and
morphometric analysis probably give more sensitive and specific results in identifying
chromosomally abnormal abortion.