Epithelial membrane antigen in cells from the uterine cervix: immunocytochemical staining of cervical smears

A comparison of epithelial membrane antigen overexpression in benign and malignant endometrium

OBJECTIVE

The aim of this study was to analyze the value of epithelial membrane antigen (EMA) overexpression in benign and malignant endometrium and its prognostic significance.

METHODS

EMA immunostaining was performed in 178 paraffin-embedded specimens including 105 endometrial cancers, 40 endometrial hyperplasias, and 33 benign endometriums. EMA immunostaining was correlated with traditional prognostic factors and progression-free survival in endometrial cancer specimens.

RESULTS

EMA overexpression was observed more frequently in adenocarcinomas (60%) than in hyperplasias (15%) or benign endometrium (9.1%). EMA overexpression was observed in two patients with endometrial hyperplasia who progressed to carcinoma. In adenocarcinomas, EMA overexpression had a positive correlation with nonendometrioid subtypes (P = 0.012). In multivariate analysis, FIGO stage (P = 0.025) and EMA overexpression (P = 0.017) were independent prognostic factors for progression-free survival.

CONCLUSIONS

EMA overexpression appears to be a marker of malignant transformation in the endometrium and it is an independent predictor of recurrent disease in endometrial cancer.

Can flow cytometry reduce the workload for cervical screening? The results of a series of 622 specimens

A simple method permitting the flow cytometric examination of cervical specimens has been developed and an assessment made of the feasibility of relying on this method to screen women for cervical neoplasia. Examination of four flow cytometric parameters showed differences between morphologically normal and abnormal specimens and allowed identification of a proportion of the normal specimens. The system had a false negative rate of 8%. Our experience with cervical specimens has revealed a number of problems associated with their examination by flow cytometry and these are discussed.

Cytoplasmic reactivity with the monoclonal antibody HMFG1 as a marker of cervical glandular atypia

Cervical adenocarcinomas show cytoplasmic reactivity with the monoclonal antibody HMFG1 in contrast to the luminal border (cuticular) staining seen in normal endocervical glands and microglandular hyperplasia. HMFG1 was applied to 15 cases of cervical glandular atypia: thirteen showed cytoplasmic reactivity similar to that seen in overt endocervical neoplasia. This pattern of reactivity seems to be a useful marker of cervical glandular atypia and further supports its suggested place in the development of adenocarcinoma.

Automated screening of cervical smears using immunocytochemical staining: a possible approach

A preliminary analysis was undertaken to ascertain whether a Leitz TAS (Texture Analyse System) video camera system, which is computer controlled, could be used to detect abnormal cells in cervical smears. Immunocytochemical together with haemalum nuclear staining was used for the epithelial membrane antigen. It was possible to detect abnormal cells in routinely prepared smears taken from patients with various degrees of cervical neoplasia, including the earliest stages, but metaplastic cells were not detected by the system. Smears from patients assessed as normal by routine cytology gave a low incidence of positive results due to occasional overlapping of cells or the presence of air bubbles. This system seems to offer a new possibility for rapid automated cytometry of cervical smears.