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Prognostic significance of combined conventional and immunocytochemical cytology for peritoneal washings in endometrial carcinoma
Author(s) -
Luo MingLiang,
Sakuragi Noriaki,
Shimizu Michio,
Seino Kuniyoshi,
Okamoto Kazuhira,
Kaneuchi Masanori,
Ebina Yasuhiko,
Okuyama Kazuhiko,
Fujino Takafumi,
Sagawa Tadashi,
Fujimoto Seiichiro
Publication year - 2001
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.9017
Subject(s) - medicine , immunostaining , carcinoma , lymph node , pathology , metastasis , adenocarcinoma , clear cell carcinoma , oncology , immunohistochemistry , cancer
BACKGROUND Noncancerous cells simulating adenocarcinoma cells may interfere with the analysis of peritoneal cytology (PC) in patients with endometrial carcinoma. Immunocytochemistry (ICC) may improve the diagnosis of PC. METHODS PC slides from 115 patients with endometrial carcinoma were reviewed. Suspicious or positive cell clusters were recovered with a cell transfer method and were subjected to ICC for MOC‐31, cytokeratin 5/6, and p53. Conventional Papanicolaou staining and ICC results were compared directly on the same cells. RESULTS By combined conventional and immunocytochemical PC (CONV‐ICC‐PC), cytodiagnosis was positive in 18 of 115 patients (15.7%) and suspicious in 3 of 115 patients (2.6%). According to a multivariate Cox regression analysis of patients with tumors confined to the uterus that included grade, myometrial invasion, cervical involvement, and CONV‐ICC‐PC, only CONV‐ICC‐PC was an independent prognostic factor ( P < 0.05). A multivariate analysis for all of the patients studied that compared CONV‐ICC‐PC with staging variables revealed that only peritoneal metastasis ( P < 0.0001) and lymph node metastasis ( P < 0.01) were independent prognostic factors. When peritoneal metastases were excluded, CONV‐ICC‐PC ( P < 0.01) and lymph node metastasis ( P < 0.0025) were the independent prognostic factors. By cell transfer and p53 immunostaining in samples from 14 patients with malignant cells in their peritoneal washings, no deaths occurred among 5 patients with negative p53, whereas 5 of 9 patients with positive p53 died of disease at the time of data analysis. CONCLUSIONS MOC‐31 immunostaining improves the diagnosis of PC in endometrial carcinoma. Positive PC is an important prognostic factor for patients with endometrial carcinoma confined to the uterus. The p53 positive cells in PC have possible prognostic significance. Cancer (Cancer Cytopathol) 2001;93:115–123. © 2001 American Cancer Society.