ArticleCureus2026
Resolving Morphological Ambiguity in Molar Pregnancy: The Diagnostic Role of p57 Immunohistochemistry.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the diagnostic utility of p57 immunohistochemistry (IHC) in differentiating complete and partial hydatidiform mole (PHM) from non-molar pregnancies, with emphasis on resolving morphologically ambiguous cases. MATERIALS AND
methodsThis hospital-based cross-sectional study was conducted in a tertiary referral centre from March 2024 to October 2025. A total of 60 histopathologically diagnosed cases of complete hydatidiform mole (CHM), PHM, and non-molar pregnancies were included. Tissue sections were examined on H&E staining for morphological features, followed by p57 IHC on paraffin-embedded sections. Nuclear staining in villous cytotrophoblasts and stromal cells was evaluated. Statistical analysis was performed using appropriate tests, with p < 0.05 considered significant.
resultsOf 60 cases, 30 were non-molar and 30 molar pregnancies (12 complete, 14 partial, four unclassified on H&E). All non-molar cases showed positive p57 expression. Among CHMs, 91.7% were p57 negative, while 78.6% of PHMs were positive. Notably, 21.4% of cases initially diagnosed as PHMs lacked p57 expression and were subsequently categorised as CHMs based on combined histomorphological evaluation and immunohistochemical findings. Overall, p57 IHC led to reclassification in 13.3% of cases, mainly involving unclassified and PHMs. A significant association was observed between diagnosis and p57 expression (p < 0.001), driven by non-molar positivity and CHM negativity.
conclusionp57 IHC is a valuable adjunct to routine histopathology for differentiating CHM from PHM. Its use significantly improves diagnostic accuracy, particularly in early gestation and morphologically ambiguous cases, thereby facilitating appropriate clinical management, follow-up, and patient counselling.
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