Two cases of gestational trophoblastic neoplasia with multiple molar emboli-like lung lesions after evacuation of hydatidiform mole

s / Placenta 36 (2015) A1eA60 A22 34.8% of the single-layer group, 23.3% of double-layer group (p1⁄40.21). By the suture method (interrupted or continuous) of inner layer of myometrium, accreta occurred in 22.7% of the interrupted group, 28.9% of continuous group (p1⁄40.34). Conclusion: The caesarean techniques varied widely in Japan. It should be markedly mentioned that interrupted sutures were introduced at uterine myometrium. P1.30. TWO CASES OF GESTATIONAL TROPHOBLASTIC NEOPLASIA WITH MULTIPLE MOLAR EMBOLI-LIKE LUNG LESIONS AFTER EVACUATION OF HYDATIDIFORM MOLE Yuko Tanizaki, Madoka Yamamoto, Shigetaka Yagi, Naoyuki Iwahashi, Tamaki Yahata, Sakiko Nanjo, Mika Mizoguchi, Aya Kobayashi, Michihisa Shiro, Nami Ota, Yasushi Mabuchi, Sawako Minami, Kazuhiko Ino. Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan It is known that hydatidiform molar vesicles can migrate via blood flow to the lung before, at the time of, or after evacuation of hydatidiform mole. These lesions may be detected using lung CT scans, but usually not by plain chest X-ray that is an appropriate investigative tool for counting the number of lung metastasis to evaluate the FIGO risk score. However, clinicopathological significance of these small multiple lesions remains unclear and also it is still controversial whether these lesions are considered as “embolism” or true “metastasis”. We experienced two cases of low risk gestational trophoblastic neoplasia (GTN) with multiple (more than 8) lung lesions after molar pregnancy. Case1: A 28-year-old woman underwent dilution and curettage (DC a: 2-3 times, b: more), by causes of RPL iAnti-phospholipid antibody syndrome (APLs: Positive for antiphospholipid antibodies) , iithrombophilia, iii thyroid hormone abnormalities, iv malformation of uterus, v chromosomal translocation, vi other chromosomal abnormality, vii unknown causes, and by treatments (I:lowdose aspirin; LDA, II:LDA and/or Heparin). Result: 1.No significant differences betweengroupAandBbyage andby times of PRL. 2. Frequency of causes: i 23.1%, ii 19.6%, iii 5.0%, iv 1.7%, v 1.6%, vi 4.4%, vii 44.6%. There were no significant differences except vii, between groups A and B. 3. Rate of successful pregnancy: It was decreased according with age. There was not significantly difference between a and b. (81.3 vs 68.3%; NS) 4. Treatments: IvsII(85.8 vs 79.2%; NS). Group A; (85.3 vs 78.1%; NS), group B; (87.5 vs 81.8%; NS). Patients with 1, I vs II (90.1 vs 74.2%; p1⁄40.03), whereas2, (93.2 vs 80.8%; NS). Under 34 years old: I vs II (94.9% vs 83.7%; pu003c0.01), especially, in group A; (95.8 vs 37.5%; pu003c0.01) whereas in group B; (90.0 vs 8.3.3%; NS) Conclusion: The most prominent finding of the study was that Heparin was extremely effective to the group of primary RPL under 34 years old. This result may contribute to make a decision for juvenile women. P1.32. THE EXPRESSION OF ADAM (A DISINTEGRIN AND METALLOPROTEINASE) GENES IN HUMAN FIRST-TRIMESTER VILLOUS AND EXTRAVILLOUS TROPHOBLAST CELLS Hironori Takahashi , Dongwei Zhao , Akihide Ohkuchi , Shigeki Matsubara , Toshihiro Takizawa . 1 Jichi Medical University, Tochigi, Japan; Nippon Medical School, Tokyo, Japan Objectives: A disintegrin and metalloproteinases (ADAMs) belong to the member of metzincins that play important roles in the proteolytic degradation of the extracellular matrix for cell invasion. However, few studies have done on the expression of ADAM subtypes expressed in human first-trimester trophoblast cells. The aim of this studywas to elucidate the differential expression profiles of ADAM genes between first trimester villous trophoblast (VT) cells and extravillous trophoblast (EVT) cells. Methods: First trimester placentas (the 7d13th gestational week, n1⁄417) were obtained from patients who underwent legal abortions and provided informed consent using protocols approved by our institutional ethics committees. We isolated EVT cells from explanted human first trimester chorionic villi and analyzed themRNA expression levels of five genes of the ADAM family (i.e., ADAMTS1, ADAMTS2, ADAM10, ADAM12, and ADAM17) using real-time PCR. Chorionic villous tips were defined as VT cells. Results: Among five ADAM genes examined in this study, ADAMTS1 was expressed at a significantly higher level in EVT cells than in VT cells. In contrast, both ADAM10 and ADAM12were expressed at significantly higher levels in VTcells than in EVTcells. In addition, we compared the expression of the genes in each cell type of middle (7d8th gestational week) versus late (10d13th week) first trimesters. Conclusion: These results suggest that first trimester trophoblast cells express ADAM genes in cell typeand gestational age-dependent manners. P1.33. THE EFFECTS OF ANGIOGENIC GROWTH FACTORS ON FIRST TRIMESTER TROPHOBLAST INVASION AND PROLIFERATION Prabha Andraweera, Amanda Highet, Gary Heinemann, Claire Roberts. School of Paediatrics and Reproductive Health, The Robinson Research Institute, University of Adelaide, Adelaide, Australia Introduction: Deficient invasion of trophoblast cells into the maternal decidua is implicated in the pathogenesis of preeclampsia and intrauterine growth restriction. While the importance of low oxygen tension on the intrauterine environment is recognized, the molecular mechanisms that regulate trophoblast invasion are still not clear. Vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) are potent angiogenic factors that promote endothelial cell invasion. We aimed to investigate the expression of VEGF and PlGF by first trimester trophoblasts in response to oxygen tension and their effect on proliferation and invasion through extracellular matrix (ECM). Methods: The HTR-8/SVneo first trimester trophoblast cell line was utilized. Expression of mRNA for VEGFA, PGF, and their receptors KDR and FLT1 was determined by qRT-PCR. Levels of VEGFA and PlGF in the cell culture supernatant were measured using ELISA. The effects of treatment with exogenous VEGFA and PlGF on trophoblast proliferation and invasion through reconstituted ECM (Matrigel) in 20%, 5% and 1% O2 over 6 hours were assessed.