Investigation of the activity of podocalyx in the etiopathogenesis of placenta accreta spectrum (PAS)

Placenta Accreta Spectrum (PAS), which includes abnormal placental invasions such as placenta accreta, increta, and percreta, are pregnancy-related complications that can cause severe morbidity and mortality. Podocalyxin (PCX) is a protein associated with tumor invasion and metastasis. Since deep myometrial invasion by trophoblasts is also present in PAS, we investigated whether podocalyxin could serve as an immunohistochemical marker for the early diagnosis of PAS by examining its immunohistochemical expression. The study group consisted of 44 cases diagnosed histopathologically with PAS who underwent peripartum hysterectomy, while the control group included 16 cases who underwent peripartum hysterectomy for reasons other than PAS. Sections were taken from paraffin blocks belonging to both groups and were immunohistochemically stained for podocalyxin, Vascular Endothelial Growth Factor (VEGF), and Ki-67, followed by immunoreactivity scoring under light microscopy for each parameter. In our study, compared to the control group, the PAS group showed a statistically significant increase in immunoreactivity scores for podocalyxin (p<0.001), VEGF (p<0.001), and Ki-67 (p<0.001). In conclusion, podocalyxin may be investigated as a biomarker for the early diagnosis of PAS.