Immunohistochemical and Ultrastructural Features of Multinucleated Giant Trophoblast Cells in Abnormally Invasive Placenta

The aim of the study was to assess the morphological, ultrastructural, and immunohistochemical features of multinucleated giant trophoblast cells (MGTCs) within the myometrium of women (at 34– 38 weeks of gestation) presenting with abnormally invasive placenta.

Material and methods. The study included 31 pregnant women aged 27–43 years, of whom 19 women (at 34–38 weeks of gestation) had pathological placental attachment, with identified placenta accreta (n=7) and placenta increta (n=12) into the uterine wall. The comparison group consisted of women (n=12) without pathological placental attachment. Myometrial fragments were fixed in 10% formalin solution, embedded in paraffin, and stained with hematoxylin and eosin. Immunohistochemical examination was performed on paraffin sections of the placenta using primary antibodies to cytokeratin 8, CD₆₈, TF (tissue factor), CD₁₆₃, CD₂₀₆, CD₁₄, CD₁₆, IGFBP-1, placental lactogen (PL), and bhCG; ultrastructural features of MGTCs were also studied.

Results. The epithelial phenotype of MGTCs was confirmed by the detection of cytokeratin 8, weak expression of placental lactogen, b-hCG, tissue factor, and the absence of expression of both macrophage lineage markers (CD₆₈, CD₂₀₆, CD₁₄, CD₁₆, CD₁₆₃) and the decidual cell marker (IGFBP-1). In samples from the comparison group, MGTCs were sparse. The identified ultrastructural features MGTCs such as a significant number of granular endoplasmic reticulum cisternae, the presence of numerous mitochondria, and Golgi complex structures — indicate their high synthetic and secretory activity. At the same time, the presence of multiple microvilli on their surface suggests the capacity for further invasion, which may be particularly important in placenta increta.

Conclusion. Thus, the epithelial origin of MGTCs was confirmed, and their high synthetic activity, as well as their ability to invade and migrate into the uterine wall, was demonstrated.

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