Diagnostic Utility of TSSC3 and RB1 Immunohistochemistry in Hydatidiform Mole
Round 1
Reviewer 1 Report
In this paper authors conducted a study on three gestational diseases : Complete mole (CM),– Partial mole(PM) and Non-molar abortus(NMA) using antibodies of paternal-imprinted (RB1, TSSC3, and DOG1) and maternal-imprinted (DNMT1 and GATA3) genes and established TSSC3 and RB1 could serve as a useful adjunct to p57 for the discrimination of complete mole from partial mole and non-molar abortus.
Based on their data few questions need to answer.
Was the three patients showing positivity to RB1 in CM also positive to TSSC3?
Did you conduct any correlation study between the level of β-hCG and TSSC3 and RB1 in all patients and if yes was there any?
Author Response
Reviewer 1
In this paper authors conducted a study on three gestational diseases: Complete mole (CM),– Partial mole (PM) and Non-molar abortus (NMA) using antibodies of paternal-imprinted (RB1, TSSC3, and DOG1) and maternal-imprinted (DNMT1 and GATA3) genes and established TSSC3 and RB1 could serve as a useful adjunct to p57 for the discrimination of complete mole from partial mole and non-molar abortus.
Based on their data few questions need to answer.
1) Was the three patients showing positivity to RB1 in CM also positive to TSSC3?
Response: Thank you for the comments.
Of the 3 cases of CM with RB1 positivity, 2 of them were negative toward TSSC3 and one was positive. See supplementary table 2.
No. |
Sample No. |
βhCG (mIU/mL) |
Diagnosis |
TSSC3 |
RB1 |
||
Intensity |
% |
Intensity |
% |
||||
1 |
CM001 |
170,624 |
CM |
- |
0 |
1+ |
30 |
2 |
CM004 |
583,933 |
CM |
1+ |
100 |
1+ |
30 |
3 |
CM005 |
170,000+ |
CM |
- |
0 |
1+ |
30 |
4 |
CM006 |
NA |
CM |
- |
0 |
2+ |
20 |
5 |
CM007 |
67,899.50 |
CM |
- |
0 |
- |
0 |
6 |
CM008 |
186,596 |
CM |
- |
0 |
2+ |
30 |
7 |
CM009 |
542,643 |
CM |
- |
0 |
2+ |
30 |
8 |
CM010 |
670,773.80 |
CM |
- |
0 |
2+ |
10 |
9 |
CM011 |
1,000,000 |
CM |
1+ |
20 |
2+ |
40 |
10 |
CM012 |
200,382 |
CM |
- |
0 |
2+ |
30 |
11 |
CM013 |
25,000 |
CM |
- |
0 |
2+ |
30 |
12 |
CM014 |
34,985.90 |
CM |
- |
0 |
2+ |
33 |
13 |
CM016 |
187,479.50 |
CM |
- |
0 |
2+ |
20 |
14 |
CM017 |
NA |
CM |
1+ |
20 |
2+ |
20 |
15 |
CM018 |
NA |
CM |
- |
0 |
1+ |
30 |
16 |
CM019 |
NA |
CM |
- |
0 |
2+ |
100 |
17 |
CM020 |
NA |
CM |
- |
0 |
2+ |
30 |
18 |
PM002 |
184,108.50 |
CM |
3+ |
20 |
2+ |
50 |
19 |
PM003 |
181,113.20 |
CM |
2+ |
50 |
2+ |
40 |
20 |
PM005 |
NA |
CM |
1+ |
10 |
2+ |
30 |
21 |
PM006 |
NA |
CM |
1+ |
10 |
1+ |
10 |
22 |
PM007 |
400,000 |
CM |
1+ |
30 |
2+ |
20 |
23 |
PM011 |
NA |
CM |
- |
0 |
2+ |
10 |
24 |
PM012 |
79,677 |
CM |
- |
0 |
2+ |
30 |
25 |
PM014 |
89,116 |
CM |
2+ |
80 |
2+ |
10 |
26 |
PM015 |
131,942 |
CM |
- |
0 |
2+ |
40 |
27 |
PM016 |
79,284 |
CM |
- |
0 |
2+ |
30 |
28 |
PM021 |
NA |
CM |
- |
0 |
2+ |
10 |
29 |
PM022 |
NA |
CM |
- |
0 |
2+ |
60 |
2) Did you conduct any correlation study between the level of β-hCG and TSSC3 and RB1 in all patients and if yes was there any?
Response: Thank you for pointing out this.
There were a total of 19 cases of CM where the β-hCG levels were available, while PM and NMA both have 9 and 4 cases with data on β-hCG.
Of the 19 cases of CM, 6 were positive for TSSC3 and 13 cases were negative. The average level of β-hCG in positive and negative TSSC3 expressions were 406378 and 198107, respectively. There is no statistical difference in β-hCG between positive and negative TSSC3 (p = 0.1116, t-test). See table below.
As for RB1, there was only one positive case in CM, where the β-hCG was available, and 18 were negative. The average level of β-hCG in positive and negative RB1 expressions were 184108 and 272438, respectively. Unable to perform a statistical analysis as there was only one case of CM.
Complete mole: β-hCG in TSSC3
b-hCG |
TSSC3 Positive |
TSSC3 Negative |
Mean |
406378 |
198107 |
SD |
341981 |
202074 |
SEM |
139613.2 |
56045.2 |
N |
6 |
13 |
|
|
P = 0.1116 |
Complete mole: β-hCG in RB1
b-hCG |
RB1 Positive |
RB1 Negative |
Mean |
184,108.50 |
272,438 |
N |
1 |
18 |
Author Response File: Author Response.docx
Reviewer 2 Report
The manuscript "Diagnostic utility of TSSC3 and RB1 immunohistochemistry in hydatidiform mole" is an interesting manuscript on the role of TSSC3 and RB1 immunohistochemistry in hydatidiform mole. The work is original and well structured, giving important novelty to scientific literature. The design of the project is appropriate and the results are significant. The number of patients is not so high, but, considering the rare frequency of this clinical condition, it is appropriate. The statistical analysis is well conducted and the language is acceptable.
It represents a valid work and it gives the opportunity to focus attention on a better diagnostic strategy for an early diagnosis of hydatidiform mole.
Author Response
Response: Thank you for the comments.
Author Response File: Author Response.docx
Reviewer 3 Report
the manuscript is interesting, well illustrated and generally well written. The manuscript can be accetped in the present form.
Author Response
Response: Thank you for the comments.
Author Response File: Author Response.docx