Hydatidiform mole diagnostics using circulating gestational trophoblasts isolated from maternal blood

• Main Authors: Lone Sunde, Ripudaman Singh, Katarina Ravn, Palle Schelde, Estrid Stæhr Hansen, Niels Uldbjerg, Isa Niemann, Lotte Hatt
• Format: Article
• Language: English
• Published: Wiley 2021-01-01
• Series: Molecular Genetics & Genomic Medicine
• Subjects: androgenetic; cell‐free nucleic acids; circulating neoplasm cells; other circulating cells; diploidy; genotyping techniques
• Online Access: https://doi.org/10.1002/mgg3.1565

Abstract Background In gestational trophoblastic disease, the prognosis is related to the genetic constitution. In some cases, taking a biopsy is contraindicated. Methods In a pregnant woman, ultrasound scanning suggested hydatidiform mole. To explore if the genetic constitution can be established without taking a biopsy (or terminating the pregnancy), cell‐free DNA and circulating gestational trophoblasts were isolated from maternal blood before evacuation of the uterus. The evacuated tissue showed the morphology of a complete hydatidiform mole. Without prior whole‐genome amplification, short tandem repeat analysis of 24 DNA markers was performed on the samples, and on DNA isolated from evacuated tissue, and from the blood of the patient and her partner. Results Identical genetic results were obtained in each of three circulating gestational trophoblasts and the evacuated tissue, showing that this conceptus had a diploid androgenetic nuclear genome. In contrast, analysis of cell‐free DNA was less informative and less specific due to the inherent presence of cell‐free DNA from the patient. Conclusion Our results show that it is possible to isolate and analyze circulating gestational trophoblasts originating in a pregnancy without maternal nuclear genome. For diagnosing gestational trophoblastic diseases, genotyping circulating gestational trophoblasts appears to be superior to analysis of cell‐free DNA.