AI Article Synopsis

  • This study investigated the molecular mechanisms of how complete hydatidiform moles (CHM) can lead to post-molar gestational trophoblast neoplasia (GTN) using RNA sequencing (RNA-seq) on samples from 13 patients.
  • By comparing gene expression between patients who developed GTN and those who had spontaneous remission, researchers identified 281 differentially expressed genes and focused on the transcription factor XBP1, which showed significant activation in the GTN group.
  • The research demonstrated that XBP1 plays a crucial role in increasing the migration and invasive abilities of trophoblast cells, as well as contributing to tumor growth in animal models, highlighting its potential as a key factor in the progression from CHM to GT

Article Abstract

Objective: A complete hydatidiform mole (CHM) is a common disease and is known to develop post-molar gestational trophoblast neoplasia (GTN). However, the molecular mechanisms underlying the progression of CHM to post-molar GTN remain largely unknown. In this study, we investigated the molecular factors associated with the progression using RNA-seq.

Methods: We included 13 patients with CHM and performed RNA-seq using freshly frozen samples. We identified differentially expressed genes between patients who developed GTN (GTN group) and those who achieved spontaneous remission after uterine evacuation (SR group), and performed pathway analysis. Then, functional analyses were performed on choriocarcinoma (JAR and JEG-3) and CHM (Hmol1-3B and Hmol1-2C) cells. Moreover, we evaluated the in vivo tumorigenicity of XBP1-overexpressed Hmol1-3B cells.

Results: The gene expression profiles were separated into two groups, and an upstream regulator analysis was performed using 281 differentially expressed genes. We focused on transcription factors and identified that 33 transcription factors were activated in the GTN group. Then, excluding those with low expression levels in clinical samples and cell lines, XBP1 was selected for further analysis. Additionally, XBP1 downregulation significantly decreased the migration and invasive abilities of choriocarcinoma cells, whereas XBP1 overexpression significantly increased the migration and invasive abilities of CHM cells. Furthermore, animal experiments showed that tumor weight and blood human chorionic gonadotropin (hCG) levels were significantly higher in the XBP1-overexpressing Hmol1-3B-bearing mice than those in the control mice.

Conclusion: RNA-seq identified XBP1 as a key factor in post-molar GTN, suggesting it contributes to the development of post-molar GTN.

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http://dx.doi.org/10.1016/j.ygyno.2024.08.023DOI Listing

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Article Synopsis
  • This study investigated the molecular mechanisms of how complete hydatidiform moles (CHM) can lead to post-molar gestational trophoblast neoplasia (GTN) using RNA sequencing (RNA-seq) on samples from 13 patients.
  • By comparing gene expression between patients who developed GTN and those who had spontaneous remission, researchers identified 281 differentially expressed genes and focused on the transcription factor XBP1, which showed significant activation in the GTN group.
  • The research demonstrated that XBP1 plays a crucial role in increasing the migration and invasive abilities of trophoblast cells, as well as contributing to tumor growth in animal models, highlighting its potential as a key factor in the progression from CHM to GT
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Contraceptive use following gestational trophoblastic disease: A systematic review.

Contraception

September 2024

Division of Complex Family Planning, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, United States. Electronic address:

Objective: To systematically review the effect of contraceptive methods following gestational trophoblastic disease (GTD) on timing of beta-human chorionic gonadotropin (hCG) remission, risk of post-molar gestational trophoblastic neoplasia (GTN), risk of unintended incident pregnancy, and interactions between contraceptive methods and disease treatment.

Study Design: We conducted a search of primary literature with search terms related to GTD and contraception through April 2023 in PubMed and extrapolated our search to other platforms. Randomized controlled trials, observational studies and case reports were eligible for inclusion if they reported on patients with known GTD who received a contraceptive method for pregnancy prevention.

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Background/aim: Single-agent chemotherapy typically has curative outcomes in patients with low-risk gestational trophoblastic neoplasia (GTN). Although surgical intervention is a potential alternative, its efficacy in these patients remains unclear. This report describes a case in which surgical excision of a uterine polypoid lesion resolved chemotherapy-resistant low-risk GTN.

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