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Few biologic markers can predict subsequent development of persistent gestational trophoblastic neoplasia (GTN) requiring chemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Suppression subtractive hybridization (SSH) combined with cDNA microarray was used to compare the differential expression pattern of HM that spontaneously regressed and that subsequently developed metastatic GTN. Tissue\u2010specific chips were constructed from the subtracted cDNA libraries, followed by cDNA microarray analysis. Verification by quantitative RNA analysis by real\u2010time polymerase chain reaction (PCR) and immunohistochemical analysis was performed in 23 genotyped complete HM.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Sixteen differentially expressed transcripts were identified. Quantitative RNA analysis confirmed down\u2010regulation of ferritin light polypeptide (FTL) (<jats:italic>P<\/jats:italic> = 0.037) and insulin\u2010like growth factor binding protein 1 (IGFBP1) (<jats:italic>P<\/jats:italic> = 0.037) in HM that subsequently developed GTN when compared with those HM that regressed. Immunohistochemical analysis further confirmed reduced IGFBP1 protein (<jats:italic>P<\/jats:italic> = 0.03) expression in HM that developed GTN.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Findings showed that reduced expression of genes related to cell invasion and immunosuppression, especially FTL and IGFBP1, were associated with development of GTN, and this finding may provide a better understanding of the pathogenesis of GTN. The potential application of FTL and IGFBP1 in management of patients with HM should be explored. 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