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Norimatsu Y, Maeda Y, Malara N, Fulciniti F, Kobayashi TK. A review of the directly sampled endometrial cytology on LBC samples: Classification, microscopic criteria and beyond. Cytopathology 2024; 35:350-361. [PMID: 38050704 DOI: 10.1111/cyt.13342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 12/06/2023]
Abstract
The Yokohama System for Reporting Endometrial Cytology (TYS) has been proposed by an expert meeting under the auspices of the International Academy of Cytology (IAC) in May 2016 at the IAC in Yokohama. Since its introduction, the TYS has been receiving worldwide acceptance, and this review aims to assess its global impact. The adoption of endometrial cytology as a diagnostic procedure has been hampered in the past by difficulties arising in interpreting the cellular findings due to a number of factors (such as excess blood, cellular overlapping and the complex physiology of endometrium). Recently, the use of liquid-based cytology (LBC), with its ability to remove blood and mucus and to distribute cells uniformly in a thin layer on the slide, has provided an opportunity to re-evaluate the role of endometrial cytology. LBC is a useful tool in the cytologic diagnosis and follow-up of endometrial abnormalities, which remains complementary to the emerging molecular diagnostic cytopathology. The study of LBC from endometrial cytology could be challenging since it is affected by numerous look-alikes and diagnostic pitfalls. This review discusses these various entities and takes into consideration the ancillary techniques that may be useful in the diagnostic procedure. In conclusion, our review of the published data suggests that the TYS is a valid classification scheme that has been widely accepted by cytopathologists globally, is highly reproducible and makes a valuable contribution to clinical therapeutic management. At present, molecular cytopathology is a rapidly evolving field of modern cytopathology, which underlines the effective interplay between genomics and cytology. This review aims to provide a comprehensive review of the drawbacks of endometrial cytopathology, particularly in terms of endometrial cancer diagnosis and molecular testing.
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Affiliation(s)
- Yoshiaki Norimatsu
- Departments of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Ehime, Japan
| | - Yoshinobu Maeda
- Department of Diagnostic Pathology, Toyama Red Cross Hospital, Toyama, Japan
| | - Natalia Malara
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Franco Fulciniti
- Department of Pathology, Unilabs Switzerland SA, Basel, Switzerland
| | - Tadao K Kobayashi
- Educational Institution Tenri University, Member of the Board, Nara, Japan
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2
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Arakawa Y, Tano Y, Fujii M, Imai Y, Norimatsu Y, Yasukawa M, Watanabe M, Yamada T. The H3K9 demethylase plant homeodomain finger protein 2 regulates interleukin 4 production in CD4 + T cells. Cytokine 2024; 175:156506. [PMID: 38241965 DOI: 10.1016/j.cyto.2024.156506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/04/2024] [Accepted: 01/12/2024] [Indexed: 01/21/2024]
Abstract
CD4+ T cells play a key role in the immune response via their differentiation into various helper T cell subsets that produce characteristic cytokines. Epigenetic changes in CD4+ T cells are responsible for cytokine production in these subsets, although the exact molecular mechanisms remain unclear. Therefore, we investigated the effects of plant homeodomain finger protein 2 (PHF2), a histone H3K9 demethylase, on cytokine production in CD4+ T cells using T cell-specific Phf2-conditional knockout (cKO) mice in this study. we showed that interleukin 4 (Il4) expression was significantly decreased in Phf2-cKO CD4+ T cells compared to that in wild-type cells. To further elucidate the role of PHF2 in vivo, we assessed immune responses in a mouse model of ovalbumin (OVA)-induced atopic dermatitis. Phf2-cKO mice exhibited lower serum levels of OVA-specific IgE than those in wild-type mice. These findings suggest that PHF2 plays a role in promoting T helper 2 cell (Th2) function and may contribute to the pathogenesis of Th2-related allergies such as atopic dermatitis. This study demonstrated the impact of PHF2 on cytokine production in CD4+ T cells for the first time. Further studies on the PHF2-mediated epigenetic mechanisms may lead to the development of treatments for a variety of immune diseases.
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Affiliation(s)
- Yuya Arakawa
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Ehime, Japan; Department of Clinical Laboratory and Biomedical Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuzuki Tano
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Ehime, Japan
| | - Moe Fujii
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Ehime, Japan
| | - Yuuki Imai
- Department of Pathophysiology, Graduate School of Medicine, Ehime University, Toon, Ehime, Japan
| | - Yoshiaki Norimatsu
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Ehime, Japan
| | - Masaki Yasukawa
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Ehime, Japan
| | - Mikio Watanabe
- Department of Clinical Laboratory and Biomedical Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takeshi Yamada
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Ehime, Japan.
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3
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Odashima H, Yoshioka H, Minami K, Miyakawa K, Horie K, Norimatsu Y, Yanoh K, Watanabe J. Morphometrical Differences among Endometrial Endometrioid Carcinoma Grade 1, Grade 3, and Serous Carcinoma in Endometrial Liquid-Based Cytology Preparations. Acta Cytol 2022; 66:524-531. [PMID: 36096095 DOI: 10.1159/000525948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/05/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In Japan, the direct smearing preparation (conventional preparation) has been widely used for cytological examination of the endometrium. Problems with the conventional preparation can be dissolved by liquid-based cytology (LBC) preparation. The Yokohama System is a method for reporting endometrial cytology, but the system lumps cancers together and does not distinguish between histological types. The objective of this study was to clarify morphometrical differences among endometrial endometrioid carcinoma grade 1 (G1), grade 3 (G3), and serous carcinoma (Serous) by image analysis of endometrial LBC. METHODS Using Papanicolaou smears prepared by LBC after sampling with a brush from 32 G1, 16 G3, and 16 Serous patients, image analysis was performed concerning the following 11 items: (1) number of layers of cluster, (2) area of cluster, (3) perimeter of cluster, (4) roundness of cluster, (5) complexity of cluster, (6) area of nucleus, (7) perimeter of nucleus, (8) roundness of nucleus, (9) complexity of nucleus, (10) area of nucleolus, and (11) nucleolus/nucleus (N/N) ratio. The data were statistically compared among G1, G3, and Serous. RESULTS Significant differences were observed in the number of layers of cluster (G1<G3<Serous), area of cluster (G1>G3<Serous), area of nucleus (G1<G3<Serous), area of nucleolus (G1<G3<Serous), roundness of cluster (G1>G3, G1>Serous), complexity of cluster (G1<G3, G1<Serous), roundness of nucleus (G1<Serous), complexity of nucleus (G1>Serous), and N/N ratio (G1>G3, G3<Serous). CONCLUSION The number of layers and area of cluster, complexity of cluster, area and complexity of nucleus, area of nucleolus, and N/N ratio were suggested to be useful for the differentiation of histological types among G1, G3, and Serous. Particularly, differences in the number of layers of cluster, size of nucleus, and size of nucleolus among histological types were large and are considered to be potentially effective points of differential diagnosis.
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Affiliation(s)
- Hirokazu Odashima
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan.,Anatomic Pathology Laboratory, Hirosaki University Hospital, Hirosaki, Japan
| | - Haruhiko Yoshioka
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Kouki Minami
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Keita Miyakawa
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Kayo Horie
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Yoshiaki Norimatsu
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo, Japan
| | - Kenji Yanoh
- Department of Obstetrics and Gynecology, JA Suzuka General Hospital, Suzuka, Japan
| | - Jun Watanabe
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan.,Anatomic Pathology Laboratory, Hirosaki University Hospital, Hirosaki, Japan
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Nishikawa T, Suzuki H, Takeuchi M, Tatsumi S, Tachibana Y, Ohbayashi C, Kobayashi TK, Norimatsu Y. A study on preserving endometrial glandular architecture during preparation using BD SurePath™ liquid-based cytology reagents: Cellular fixation with preservative fluid requires at least 18 h. Cytopathology 2021; 33:357-361. [PMID: 34882854 DOI: 10.1111/cyt.13087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study aimed to determine the causes of disruption of the three-dimensional architecture of endometrial glands prepared using BD SurePath™ liquid-based cytology (SP-LBC) reagents. One sample preparation method for endometrial cytology is presented in which this three-dimensional architecture can be retained. METHODS SP-LBC specimens were prepared by the following three methods: (1) using the BD PrepMateTM (PrepMate) System after cellular fixation for 1-6 h (method A); (2) without using the PrepMate System after cellular fixation for 1-6 h (method B); and (3) using the PrepMate System after cellular fixation for at least 18 h (method C). Size and numbers of endometrial cell clusters and numbers of solitary scattered cells were then evaluated. RESULTS Significantly higher numbers of cell clusters with a major axis of 200 μm or more were yielded by method C (71.3 ± 57.2) than methods A (9.3 ± 5.9, P < 0.001) or B (44.3 ± 28.8, P < 0.05). Method B yielded significantly higher numbers of cell clusters than method A (P < 0.001). Method A (132.2 ± 107.7, p < 0.001) yielded significantly higher numbers of solitary scattered cells than methods B (29.1 ± 14.8) and C (35.7 ± 23.3). No significant difference in solitary cell numbers was found between methods B and C. CONCLUSIONS Retention of endometrial glandular architecture is rendered possible by allowing sample fixation times of 18 h or more when preparing specimens using the PrepMate System.
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Affiliation(s)
- Takeshi Nishikawa
- Department of Pathology, Nara Medical University Hospital, Nara, Japan
| | - Hisae Suzuki
- Department of Pathology, Nara Medical University Hospital, Nara, Japan
| | - Mao Takeuchi
- Department of Pathology, Nara Medical University Hospital, Nara, Japan
| | - Shigenobu Tatsumi
- Department of Pathology, Nara Medical University Hospital, Nara, Japan
| | - Yuma Tachibana
- Department of Medical Technology, Yamatotakada Municipal Hospital, Nara, Japan
| | - Chiho Ohbayashi
- Department of Diagnostic Pathology, Nara Medical University School of Medicine, Nara, Japan
| | - Tadao K Kobayashi
- Cancer Education and Research Center, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshiaki Norimatsu
- Departments of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Ehime, Japan
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Mizuno Y, Norimatsu Y, Ohno Y. Achenbach syndrome in an older man. Clin Exp Dermatol 2021; 47:768-769. [PMID: 34856004 DOI: 10.1111/ced.15042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/20/2021] [Accepted: 11/29/2021] [Indexed: 12/21/2022]
Abstract
Dermatologists should consider Achenbach syndrome in the differential diagnosis for patients with purpura on the fingers. The patient should be monitored following appropriate examination and invasive tests, such as skin biopsy or angiography, should be avoided unless necessary.
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Affiliation(s)
- Y Mizuno
- Department of Dermatology, JR Tokyo General Hospital, Tokyo, Japan.,Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Y Norimatsu
- Department of Dermatology, JR Tokyo General Hospital, Tokyo, Japan.,Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Y Ohno
- Department of Dermatology, JR Tokyo General Hospital, Tokyo, Japan
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6
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Kuzumi A, Yoshizaki A, Chiba K, Mitsuo S, Matsuda KM, Norimatsu Y, Nagai K, Omatsu J, Miyake T, Sato S. Genital necrosis with cutaneous thrombosis after COVID-19 mRNA vaccination. J Eur Acad Dermatol Venereol 2021; 36:e185-e186. [PMID: 34839563 PMCID: PMC9011818 DOI: 10.1111/jdv.17837] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- A Kuzumi
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - A Yoshizaki
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - K Chiba
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - S Mitsuo
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - K M Matsuda
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Y Norimatsu
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - K Nagai
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - J Omatsu
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - T Miyake
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - S Sato
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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7
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Norimatsu Y, Nishikawa T, Suzuki H, Hosokawa S, Yano H, Maeda Y, Kurokawa T, Shinagawa A, Kobayashi TK, Fulciniti F. The expression pattern of CD10 and CD31 identifies fine fibrovascular stroma of grade 1-endometrial endometrioid carcinomas in cytology. Cytopathology 2021; 33:362-373. [PMID: 34689374 DOI: 10.1111/cyt.13070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/05/2021] [Accepted: 10/18/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The objective of this study was to assess the diagnostic utility of CD10 in the differential diagnosis of grade 1-endometrial endometrioid carcinoma (G1-EEC) and the metaplastic changes associated with the endometrial glandular and stromal breakdown (EGBD) on liquid-based cytological (LBC) samples. METHODS (1) The type and distribution of CD10-positive cells in EGBD and G1-EEC patients were evaluated. (2) Based on the results from (1), histological and cytological specimens were double-immunostained with CD31 and CD10 to confirm whether CD10-positive tubular-canalicular material found in (1) was represented by fine threads of endometrial-type fibrovascular stroma. (3) Based on the results from (2), additional immunostaining of histological specimens was performed for CD146 and αSMA as markers of perivascular cells. RESULTS (1) CD10 positive cells showed two main patterns of expression: cytoplasmic immunoreactivity in the form of dense brown granules in EGBD and tubular-canalicular branching patterns in G1-EEC. (2) The tubular-canalicular material observed in cytological specimens of G1-EEC samples co-expressed CD10 and CD31, and was interpreted as representing fine threads of endometrial fibrovascular stroma in the corresponding histological samples. Conversely, metaplastic changes in EGBD cases, only a few CD31-positive signals were found inside the condensed stromal clusters with CD10-positive. (3) Cells surrounding the CD31-positive vascular endothelial cells expressed CD146 and αSMA; moreover, some of the thin CD10-positive fibrous stromal strands also co-expressed αSMA. CONCLUSIONS CD10 is a very useful immunomarker for distinguishing between G1-EEC and the metaplastic changes of EGBD in LBC samples.
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Affiliation(s)
- Yoshiaki Norimatsu
- Departments of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Ehime, Japan
| | - Takeshi Nishikawa
- Department of Pathology, Nara Medical University Hospital, Nara, Japan
| | - Hisae Suzuki
- Department of Pathology, Nara Medical University Hospital, Nara, Japan
| | - Sho Hosokawa
- Departments of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Ehime, Japan
| | - Hiroko Yano
- Departments of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Ehime, Japan
| | - Yoshinobu Maeda
- Department of Diagnostic Pathology, Toyama Red Cross Hospital, Toyama, Japan
| | - Tetsuji Kurokawa
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Akiko Shinagawa
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tadao K Kobayashi
- Cancer Education and Research Center, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Franco Fulciniti
- Clinical Cytopathology Service, Istituto Cantonale di Patologia, Locarno, Switzerland
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8
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Sato H, Norimatsu Y, Irino S, Nishikawa T. Efficacy of the Antigenicity-Retaining Ability of Fixative Solutions for Liquid-Based Cytology: Immunocytochemistry of Long-Term Storage. Acta Cytol 2021; 65:510-521. [PMID: 34535585 DOI: 10.1159/000518452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/11/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION/OBJECTIVE Liquid-based cytology (LBC) is advantageous as multiple stained specimens can be prepared and used for additional assays such as immunocytochemical and molecular-pathological investigations. Two types of preservative-fixative solutions (fixatives) are used for nongynecologic specimens used in the BD SurePath-LBC (SP-LBC) method, and their components vary. However, few studies have evaluated the differences in antigen-retaining ability between these fixatives. Therefore, we investigated and compared the antigen-retaining ability of the fixatives in immunocytochemical staining (ICC) under long-term storage conditions. MATERIALS AND METHODS Sediments of cultured RAJI cells (derived from Burkitt's lymphoma) were added to each fixative (red and blue) and stored at room temperature for a specified period (1 h; 1 week; and 1, 3, and 6 months). The specimens were then prepared using the SP-LBC method and subjected to ICC. Positivity rate was calculated using the specimens fixed at room temperature for 1 h as a control. Antibodies against Ki67 expressed in the nucleus and against CD20 and leukocyte common antigen (LCA) expressed on the cell membrane were used. RESULTS For CD20 and LCA, the positivity rate increased with time in the red fixative compared with that in the control. In the blue fixative, the positivity rate was highest at 1 h and was maintained at a high level throughout the storage period. In contrast, the Ki67 positivity rate was highest at 1 h in both red and blue fixatives and markedly decreased with time. Therefore, although refrigerated (8°C) storage was used, no improvement was noted. CONCLUSIONS Long-term storage is possible for cell membrane antigens at room temperature; however, it is unsuitable for intranuclear antigens. Therefore, we conclude that suitable fixative type and storage temperature differ based on antigen location. Further investigation is warranted.
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Affiliation(s)
- Hiaki Sato
- Department of Medical Technology and Clinical Engineering, Faculty of Health and Medical Sciences, Hokuriku University, Kanazawa, Japan
| | - Yoshiaki Norimatsu
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Tobe, Japan
| | - Satoshi Irino
- Department of Nursing, Ehime Prefectural University of Health Sciences, Tobe, Japan
| | - Takeshi Nishikawa
- Department of Pathology, Nara Medical University Hospital, Nara, Japan
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9
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Norimatsu Y, Irino S, Maeda Y, Yanoh K, Kurokawa T, Hirai Y, Kobayashi TK, Fulciniti F. Nuclear morphometry as an adjunct to cytopathologic examination of endometrial brushings on LBC samples: A prospective approach to combined evaluation in endometrial neoplasms and look alikes. Cytopathology 2020; 32:65-74. [PMID: 32794283 DOI: 10.1111/cyt.12902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In this study, we aimed to retrospectively investigate and confirm whether atypical nuclear findings in endometrial cytology are useful when assessed by image morphometry in liquid-based cytology (LBC) and compared with microscopic evaluation. METHODS In total, 53 cases were selected for this study, including 11 presenting proliferative endometrium, 12 with surface papillary syncytial change with endometrial glandular and stromal breakdown (EGBD-SPSC), 10 endometrioid carcinoma grade 1 (G1-EEC), 10 EEC grade 3 (G3-EEC), and 10 endometrial serous carcinomas (ESC). Nuclear image morphometry for nuclear geometric features (area, grey value, aspect ratio, internuclear distance, nucleolar diameter) was performed using ImageJ computer software. For assessing nucleoli, 3861 nuclei were measured, and for nuclear findings, except for nucleoli, 4036 nuclei were measured in total. RESULTS (a) Compared with G1-EEC, G3-EEC and ESC presented a marked increase in all six parameters (nuclear enlargement, anisonucleosis, nuclear shade, nuclear shape, irregularity of nuclear arrangement, and nucleolar size). (b) EGBD-SPSC presented a marked increase in two parameters (nuclear shade, nuclear shape) when compared with G1/G3-EEC and ESC. (c) Compared with EGBD-SPSC, EEC and ESC demonstrated a marked increase in nucleolar size (≥2.0 μm). (d) ESC presented a marked increase in nucleolar size (≥3.0 μm) when compared with G3-EEC. CONCLUSIONS Here we confirmed that atypical nuclear findings evaluated by image morphometry are as useful as microscopic evaluations in endometrial cytology. We believe that the objective evaluation of nucleolar size could contribute to an accurate diagnosis of endometrial-LBC samples.
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Affiliation(s)
- Yoshiaki Norimatsu
- Departments of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Ehime, Japan
| | - Satoshi Irino
- Department of Nursing, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Ehime, Japan
| | - Yoshinobu Maeda
- Department of Diagnostic Pathology, Toyama Red Cross Hospital, Toyama, Japan
| | - Kenji Yanoh
- Departments of Obstetrics and Gynecology and Pathology, JA Suzuka General Hospital, Mie, Japan
| | - Tetsuji Kurokawa
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yasuo Hirai
- PCL Japan Pathology and Cytology Center, PCL Inc, Saitama, Japan.,Department of Obstetrics and Gynecology, Faculty of Medicine, Dokkyo Medical University, Tochigi, Japan
| | - Tadao K Kobayashi
- Cancer Education and Research Center, Division of Health Sciences, Osaka University Graduate School of Medicine Osaka, Japan
| | - Franco Fulciniti
- Clinical Cytopathology Service, Istituto Cantonale di Patologia, Locarno, Switzerland
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10
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Matsuda KM, Yoshizaki A, Kotani H, Norimatsu Y, Kuzumi A, Fukayama M, Fukasawa T, Ebata S, Yoshizaki-Ogawa A, Asano Y, Oba K, Sato S. Serum heat shock protein 27 levels in patients with systemic sclerosis: a possible biomarker of skin sclerosis. J Eur Acad Dermatol Venereol 2020; 35:e157-e159. [PMID: 32805744 DOI: 10.1111/jdv.16885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/28/2020] [Accepted: 08/06/2020] [Indexed: 12/14/2022]
Affiliation(s)
- K M Matsuda
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - A Yoshizaki
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - H Kotani
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Y Norimatsu
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - A Kuzumi
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - M Fukayama
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - T Fukasawa
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - S Ebata
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - A Yoshizaki-Ogawa
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Y Asano
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - K Oba
- Department of Biostatistics, School of Public Health, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - S Sato
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
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11
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Norimatsu Y, Yanoh K, Hirai Y, Kurokawa T, Kobayashi TK, Fulciniti F. A Diagnostic Approach to Endometrial Cytology by Means of Liquid-Based Preparations. Acta Cytol 2019; 64:195-207. [PMID: 31473735 DOI: 10.1159/000502108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/15/2019] [Indexed: 12/12/2022]
Abstract
The adoption of endometrial cytology as a diagnostic procedure has been hampered in the past by difficulties arising in interpreting the cellular findings due to a number of factors (such as excess blood, cellular overlapping, and the complex physiology of endometrium). Recently, the use of liquid-based cytology (LBC), with its ability to remove blood and mucus and to distribute cells uniformly in a thin layer on the slide, has provided an opportunity to reevaluate the role of endometrial cytology. LBC samples are easier to screen compared to conventional ones, due to a smaller screening area and an excellent quality of cell preparations. LBC by using peculiar cytoarchitectural features is a useful tool in the cellular diagnosis and follow-up of abnormalities, which, however, remains complementary to histopathology and to the emerging molecular diagnostic cytopathology. This review discusses these various entities and takes into consideration the ancillary techniques that may be useful in the diagnostic procedure. Herein, we also summarize the process and rationale by which updates were made to the standardized terminology in 2018 and outline the contents of the new Bethesda-style classification (the Yokohama system) for the endometrial cytology.
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Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Japan,
| | - Kenji Yanoh
- Department of Obstetrics and Gynecology, JA Suzuka General Hospital, Suzuka, Japan
| | - Yasuo Hirai
- Department Obstetrics and Gynecology, Faculty of Medicine, Dokkyo Medical University, Mibumachi, Japan
- Department of Cytology, PCL Japan Pathology and Cytology Center, PCL Inc., Kawagoe, Japan
| | - Tetsuji Kurokawa
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tadao K Kobayashi
- Cancer Education and Research Center, Osaka University Graduate School of Medicine, Suita, Japan
| | - Franco Fulciniti
- Clinical Cytopathology Service, Istituto Cantonale di Patologia, Locarno, Switzerland
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12
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Nimura A, Ishitani K, Norimatsu Y, Okada K, Akizawa Y, Yanoh K, Hirai Y, Nagashima Y, Irino S, Kobayashi TK, Tabata T. Evaluation of cellular adequacy in endometrial liquid-based cytology. Cytopathology 2019; 30:526-531. [PMID: 31066127 DOI: 10.1111/cyt.12716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/01/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study evaluated cellular adequacy in endometrial liquid-based cytology (LBC) specimens. METHODS In total, 1267 cases were obtained and the rate of unsatisfactory specimen and diagnostic accuracy for malignancy were assessed. If ≥10 cellular clusters composed of ≤30 endometrial cells were found per specimen, then the sample was provisionally considered adequate. RESULTS The unsatisfactory rate (with fewer than 10 clusters) was 15.4%. Diagnostic accuracy in specimens with ≥10 clusters was significantly higher (90.5% vs 36.4%) than that in specimens with fewer than10 clusters. Moreover, the unsatisfactory rate in patients aged ≥60 years was significantly higher (33.8% vs 13.2%) than that in patients younger than 60 years. Although the unsatisfactory rate was decreased, significant differences were not found between cases with fewer than five clusters (22.6%) and fewer than 10 clusters (33.8%) in patients aged ≥60 years. Diagnostic accuracy in cases with five or more clusters was significantly higher (90.3% vs 0%) than that in cases with fewer than five clusters. CONCLUSIONS We propose that ≥10 clusters with ≥30 endometrial cells per cluster could be used as a specimen adequacy criterion for endometrial LBC. If ≥10 clusters cannot be found in patients aged ≥60 years, then the use of the alternative criterion of five or more clusters may yield satisfactory specimen adequacy.
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Affiliation(s)
- Azusa Nimura
- Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Ken Ishitani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan.,Department of Gynecology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Yoshiaki Norimatsu
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Iyo-gun, Ehime, Japan
| | - Kaoruko Okada
- Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoshika Akizawa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenji Yanoh
- Departments of Obstetrics and Gynecology, JA Suzuka General Hospital, Suzuka, Mie, Japan
| | - Yasuo Hirai
- Department of Cytology, PCL Japan Pathology and Cytology Center, PCL Inc, Kawagoe, Saitama, Japan.,Department Obstetrics and Gynecology, Faculty of Medicine, Dokkyo Medical University, Mibumachi, Shimotsuga-gun, Tochigi, Japan
| | - Yoji Nagashima
- Department of Surgical Pathology, Tokyo Women's Medical University, Tokyo, Japan
| | - Satoshi Irino
- Department of Nursing, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Ehime, Japan
| | - Tadao K Kobayashi
- Cancer Education and Research Center, Division of Health Sciences, Osaka University Graduate School of Medicine Division Health Science, Suita, Osaka, Japan
| | - Tsutomu Tabata
- Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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13
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Norimatsu Y, Yanoh K, Maeda Y, Irino S, Hirai Y, Fulciniti F, Kobayashi TK. Insulin‐like growth factor‐II mRNA‐binding protein 3 immunocytochemical expression in direct endometrial brushings: Possible diagnostic help in endometrial cytology. Cytopathology 2019; 30:215-222. [DOI: 10.1111/cyt.12677] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/13/2018] [Accepted: 12/13/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Yoshiaki Norimatsu
- Departments of Medical TechnologyFaculty of Health SciencesEhime Prefectural University of Health Sciences Tobe‐cho, Iyo‐gun Ehime Japan
| | - Kenji Yanoh
- Departments of Obstetrics and Gynecology and PathologyJA Suzuka General Hospital Suzuka Mie Japan
| | - Yoshinobu Maeda
- Department of Diagnostic PathologyToyama Red Cross Hospital Toyama City Toyama Japan
| | - Satoshi Irino
- Department of NursingFaculty of Health SciencesEhime Prefectural University of Health Sciences Tobe‐cho, Iyo‐gun Ehime Japan
| | - Yasuo Hirai
- PCL Japan Pathology and Cytology CenterPCL Inc Saitama Japan
- Department of Obstetrics and GynecologyFaculty of MedicineDokkyo Medical University Shimotsuga‐gun Tochigi Japan
| | - Franco Fulciniti
- Clinical Cytopathology ServiceIstituto Cantonale di Patologia Locarno Switzerland
| | - Tadao K. Kobayashi
- Cancer Education and Research CenterOsaka University Graduate School of Medicine Osaka Japan
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14
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Hirai Y, Sakamoto K, Fujiwara H, Kamata M, Tamura T, Yanoh K, Norimatsu Y, Kasai T, Teramoto K, Kurokawa T, Takahashi Y, Iwanari O, Suzuki M. Liquid‐based endometrial cytology using SurePath™ is not inferior to suction endometrial tissue biopsy for detecting endometrial malignancies: Midterm report of a multicentre study advocated by Japan Association of Obstetricians and Gynecologists. Cytopathology 2019; 30:223-228. [DOI: 10.1111/cyt.12657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/29/2018] [Indexed: 01/16/2023]
Affiliation(s)
- Yasuo Hirai
- PCL Japan Pathology and Cytology Center PCL Inc. Saitama Japan
- Department of Obstetrics and Gynecology Faculty of Medicine Dokkyo Medical University Tochigi Japan
| | - Kimihiko Sakamoto
- Department of Obstetrics and Gynecology NTT Medical Center Tokyo Tokyo Japan
| | - Hiroyuki Fujiwara
- Department of Obstetrics and Gynecology Jichi Medical University Tochigi Japan
| | - Masaharu Kamata
- Department of Obstetrics and Gynecology Mutual Aid Association of Public School Teachers Shikoku Central Hospital Shikokuchuou UK
| | - Takao Tamura
- Department of Obstetrics and Gynecology Mutual Aid Association of Public School Teachers Shikoku Central Hospital Shikokuchuou UK
| | - Kenji Yanoh
- Department of Obstetrics and Gynecology JA Suzuka General Hospital Suzuka Mie Japan
| | - Yoshiaki Norimatsu
- Department of Medical Technology Faculty of Health Sciences Ehime Prefectural University of Health Sciences Ehime Japan
| | - Tokuzo Kasai
- Chiba Foundation for Health Promotion& Disease Prevention Chiba Japan
| | - Katsuhiro Teramoto
- Department of Obstetrics and Gynecology Yamanashi Prefectural Central Hospital Yamanashi Japan
| | - Tetsuji Kurokawa
- Department of Gynecology and Obstetrics Faculty of Medical Sciences University of Fukui Yoshida‐Gun, Japan
| | - Yoshifumi Takahashi
- Department of Obstetrics and Gynecology Jichi Medical University Tochigi Japan
| | - Osamu Iwanari
- Department of Obstetrics and Gynecology Shimane Prefectural Central Hospital Izumo Shimane Japan
| | - Mitsuaki Suzuki
- Cancer Center Shin‐Yurigaoka General Hospital Kanagawa Japan
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15
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Fulciniti F, Yanoh K, Karakitsos P, Watanabe J, Di Lorito A, Margari N, Maeda Y, Kihara M, Norimatsu Y, Kobayashi TK, Hirai Y. The Yokohama system for reporting directly sampled endometrial cytology: The quest to develop a standardized terminology. Diagn Cytopathol 2018; 46:400-412. [DOI: 10.1002/dc.23916] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/08/2018] [Accepted: 02/01/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Franco Fulciniti
- Clinical Cytopathology Service; Istituto Cantonale di Patologia; Locarno, CH-6600 Switzerland
| | - Kenji Yanoh
- Departments of Obstetrics and Gynecology; JA Suzuka General Hospital; Mie Japan
| | - Petros Karakitsos
- Department of Cytopathology, National and Kapodistrian University of Athens; University General Hospital “Attikon”; Athens Greece
| | - Jun Watanabe
- Department of Bioscience and Laboratory Medicine; Hirosaki University Graduate School of Health Science; Aomori Japan
| | - Alessia Di Lorito
- Center of Predictive Molecular Medicine, Center for Excellence on Ageing and Translational Medicine (CeSI-MeT); University of Chieti-Pescara; Chieti Italy
| | - Niki Margari
- Department of Cytopathology, National and Kapodistrian University of Athens; University General Hospital “Attikon”; Athens Greece
| | - Yoshinobu Maeda
- Department of Diagnostic Pathology; Toyama Red Cross Hospital; Toyama Japan
| | - Maki Kihara
- Department of Obstetrics and Gynecology; Faculty of Medicine, Tokyo Women's Medical University
| | - Yoshiaki Norimatsu
- Department of Medical Technology, Faculty of Health Sciences; Ehime Prefectural University of Health Sciences; Ehime Japan
| | - Tadao K. Kobayashi
- Cancer Education and Research Center; Osaka University Graduate School of Medicine and Health Science; Osaka Japan
| | - Yasuo Hirai
- Department of Obstetrics and Gynecology; Faculty of Medicine, Dokkyo Medical University; Tochigi Japan
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16
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Norimatsu Y, Yamaguchi T, Taira T, Abe H, Sakamoto H, Takenaka M, Yanoh K, Yoshinobu M, Irino S, Hirai Y, Kobayashi TK. Inter-observer reproducibility of endometrial cytology by the Osaki Study Group method: utilising the Becton Dickinson SurePath ™ liquid-based cytology. Cytopathology 2016; 27:472-478. [PMID: 27109167 DOI: 10.1111/cyt.12342] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The purpose of the present study was to evaluate the reproducibility of the cytological diagnosis of endometrial lesions by the Osaki Study Group (OSG) method of new cytological diagnostic criteria using BD SurePath™ (SP)-liquid-based cytology (LBC). METHODS This cytological classification using the OSG method consists of six categories: (i) normal endometrium (NE), (ii) endometrial glandular and stromal breakdown (EGBD), (iii) atypical endometrial cells, cannot exclude atypical endometrial hyperplasia or more (ATEC-A), (iv) adenocarcinoma including atypical endometrial hyperplasia or malignant tumour (Malignancy), (v) endometrial hyperplasia without atypia (EH) and (vi) atypical endometrial cells of undetermined significance (ATEC-US). For this study, a total 244 endometrial samplings were classified by two academic cytopathologists as follows: 147 NE cases , 36 EGBD cases , 47 Malignant cases, eight ATEC-A cases, two EH cases and four ATEC-US cases. To confirm the reproducibility of the diagnosis and to study the inter- and intra-observer agreement further, a second review round followed at 3-month intervals, which included three additional cytopathologists. RESULTS The inter-observer agreement of NE classes improved progressively from 'good to fair' to 'excellent', with values increasing from 0.70 to 0.81. Both EGBD and Malignancy classes improved progressively from 'good to fair' to 'excellent', with values increasing from 0.62-0.63 to 0.84-0.95, respectively. The overall intra-observer agreement between the first and the second rounds was 'good to fair' to 'excellent', with values changing from 0.79 to 0.85. All kappa improvements were significant (P < 0.0001). CONCLUSION In this study, it seemed that the use of the OSG method as the new diagnostic criteria for SP-LBC preparation, may be a valid method to improve the precision (reproducibility) of endometrial cytology.
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Affiliation(s)
- Y Norimatsu
- Faculty of Health Sciences, Department of Medical Technology, Ehime Prefectural University of Health Sciences, Ehime, Japan
| | - T Yamaguchi
- Department of Pathology, Kurume University Hospital, Fukuoka, Japan
| | - T Taira
- Department of Pathology, Kurume University Hospital, Fukuoka, Japan
| | - H Abe
- Department of Pathology, Kurume University Hospital, Fukuoka, Japan
| | - H Sakamoto
- Department of Cytology, The Tohkai Cytopathology Institute, Gifu, Japan
| | - M Takenaka
- Department of Cytology, The Tohkai Cytopathology Institute, Gifu, Japan
| | - K Yanoh
- Departments of Obstetrics and Gynecology and Pathology, JA Suzuka General Hospital, Mie, Japan
| | - M Yoshinobu
- Department of Diagnostic Pathology, Toyama Red Cross Hospital, Toyama, Japan
| | - S Irino
- Faculty of Health Sciences, Department of Nursing, Ehime Prefectural University of Health Sciences, Ehime, Japan
| | - Y Hirai
- Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan
| | - T K Kobayashi
- Cancer Education and Research Center, Osaka University Graduate School of Medicine, Osaka, Japan
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17
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Ohsaki H, Sofue T, Kawakami K, Nishijima Y, Hara T, Matsunaga T, Kushida Y, Haba R, Shigematsu Y, Irino S, Norimatsu Y. WT1 immunoenzyme staining using SurePath™processed urine cytology helps to detect kidney disease. Cytopathology 2015; 27:43-9. [DOI: 10.1111/cyt.12227] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2014] [Indexed: 12/27/2022]
Affiliation(s)
- H. Ohsaki
- Department of Medical Technology; Ehime Prefectural University of Health Sciences; Ehime Japan
| | - T. Sofue
- Department of Cardiorenal and Cerebrovascular Medicine; Faculty of Medicine; Kagawa University; Kagawa Japan
| | - K. Kawakami
- Department of Cardiorenal and Cerebrovascular Medicine; Faculty of Medicine; Kagawa University; Kagawa Japan
| | - Y. Nishijima
- Department of Cardiorenal and Cerebrovascular Medicine; Faculty of Medicine; Kagawa University; Kagawa Japan
| | - T. Hara
- Department of Cardiorenal and Cerebrovascular Medicine; Faculty of Medicine; Kagawa University; Kagawa Japan
| | - T. Matsunaga
- Department of Diagnostic Pathology; Faculty of Medicine; University Hospital; Kagawa University; Kagawa Japan
| | - Y. Kushida
- Department of Diagnostic Pathology; Faculty of Medicine; University Hospital; Kagawa University; Kagawa Japan
| | - R. Haba
- Department of Diagnostic Pathology; Faculty of Medicine; University Hospital; Kagawa University; Kagawa Japan
| | - Y. Shigematsu
- Department of Clinical Laboratory; Shigei Medical Research Hospital; Okayama Japan
| | - S. Irino
- Department of Nursing; Ehime Prefectural University of Health Sciences; Ehime Japan
| | - Y. Norimatsu
- Department of Medical Technology; Ehime Prefectural University of Health Sciences; Ehime Japan
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18
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Hirai Y, Fukagawa F, Kihara M, Ishitani K, Yanoh K, Norimatsu Y, Hanada A, Matsui H. Prospective performance study of the liquid-based endometrial cytology with sampling directly from the uterine endometrium for the effective endometrial cancer screening. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e16548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Yasuo Hirai
- Tokyo Women's Medical University, Tokyo, Japan
| | | | - Maki Kihara
- Tokyo Women's Medical University, Tokyo, Japan
| | | | | | | | | | - Hideo Matsui
- Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan
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19
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Kidani T, Nakamura A, Kamei S, Norimatsu Y, Miura H, Masuno H. Overexpression of cytoplasmic β-catenin inhibits the metastasis of the murine osteosarcoma cell line LM8. Cancer Cell Int 2014; 14:31. [PMID: 24690154 PMCID: PMC3977682 DOI: 10.1186/1475-2867-14-31] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 03/26/2014] [Indexed: 02/07/2023] Open
Abstract
Background Previously, we found that treatment of LM8 murine osteosarcoma cells with genistein, an isoflavone found in soy, increased the cellular level of β-catenin and decreased its invasive and motile potential. The purpose of this study is to investigate whether the expression of β-catenin in LM8 cells is associated with metastatic potential in nude mice. To this end, we used untreated and genistein-treated LM8 cells. Methods LM8 cells were treated for 3 days with or without 50 μM genistein and harvested by trypsinization. Untreated (the control group) and genistein-treated (the genistein group) cells were subcutaneously inoculated into the backs of male nude mice. After 25 days of inoculation, the tumors, lungs, and livers were excised, fixed in 10% formalin, and embedded in paraffin. The sections of formalin-fixed, paraffin-embedded lungs and livers were stained with hematoxylin-eosin (H&E) to confirm the absence or presence of metastatic tumors. The expression of β-catenin within the primary tumor was immunohistochemically examined. Results All mice in the control group (n = 8) exhibited large primary tumors, while in the genistein group (n = 8), one mouse showed no tumor formation and the remaining seven mice exhibited smaller primary tumors compared with the control group. The tumor mass of the genistein group was 23% of that of the control group. In the control group, multiple metastatic tumors were found in the lung and/or liver and the metastatic incidence was 100% in the lung and 87.5% in the liver. Six of seven tumor-bearing mice in the genistein group developed no metastatic tumors in the lung or liver, and this group was termed the genistein/metastasis(-) subgroup. Positive β-catenin immunostaining was observed in the cytoplasm of tumor cells, and the β-catenin-labeling index was higher in the genistein/metastasis(-) subgroup than in the control group. The intensity of cytoplasmic β-catenin immunostaining was stronger in the genistein/metastasis(-) subgroup compared with the control group, and the β-catenin-labeling score was 1.9-times higher in the former subgroup than in the latter group. Conclusions Overexpression of cytoplasmic β-catenin in LM8 cells causes inhibition of the growth of primary tumors and loss of the metastatic potential to the lung and liver.
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Affiliation(s)
| | | | | | | | | | - Hiroshi Masuno
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Takooda, Tobe-cho, Iyo-gun, Ehime 791-2101, Japan.
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20
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Moran AR, Norimatsu Y, Dawson DC, MacDonald KD. Aqueous cigarette smoke extract induces a voltage-dependent inhibition of CFTR expressed in Xenopus oocytes. Am J Physiol Lung Cell Mol Physiol 2014; 306:L284-91. [PMID: 24318115 PMCID: PMC3920202 DOI: 10.1152/ajplung.00163.2013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 11/30/2013] [Indexed: 11/22/2022] Open
Abstract
The cystic fibrosis transmembrane conductance regulator (CFTR) chloride channel inhabits the apical membrane of airway epithelia, where its function is essential for mucus hydration, mucociliary clearance, and airway defense. Chronic obstructive pulmonary disease (COPD), most often a consequence of cigarette smoke (CS) exposure, affects 15 million persons in the US. Clinically, COPD is characterized by many of the salient features of cystic fibrosis lung disease, where CFTR is either absent or reduced in function. CS is an acidic aerosol (pH 5.3 to 6.3) reported to contain over 4,000 constituents. Acute CS exposure has been reported to decrease airway transepithelial voltage in vivo and short-circuit current in vitro; however, the mechanistic basis of these effects is uncertain. The goal of the studies described here was to develop a bioassay to characterize the effects of aqueous CS preparations on the channel function of CFTR. We studied aqueous CS extract (CSE) prepared in our laboratory, as well as commercial cigarette smoke condensate (CSC) in Xenopus oocytes expressing human CFTR. Application of CSE at pH 5.3 produced a reversible, voltage-dependent inhibition of CFTR conductance. CSE neutralized to pH 7.3 produced less inhibition of CFTR conductance. Serial dilution of CSE revealed a dose-dependent effect at acidic and neutral pH. In contrast, CSC did not inhibit CFTR conductance in oocytes. We conclude that one or more components of CSE inhibits CFTR in a manner similar to diphenylamine-2-carboxylate, a negatively charged, open-channel blocker.
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Affiliation(s)
- A R Moran
- Oregon Health & Science Univ., Dept. of Pediatrics, 3181 SW Sam Jackson Park Rd., CDRCP, Portland, OR 97239.
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21
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Norimatsu Y, Ohsaki H, Masuno H, Kagawa A, Teramoto N, Kobayashi TK. Efficacy of CytoLyt® hemolytic action on ThinPrep® LBC using cultured osteosarcoma cell line LM8. Acta Cytol 2014; 58:76-82. [PMID: 24157542 DOI: 10.1159/000354960] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 07/29/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The removal of blood components is necessary to improve the quality of the liquid-based cytology (LBC) preparations. In ThinPrep® (TP) samples a cell suspension in a methanol-based fixative undergoes a vacuum filtration method, whereas in SurePath™ (SP) samples a cell suspension in an ethanol-based fixative is processed through a density gradient centrifugation system prior to gravity deposition of the specimen onto a glass slide. We compared the cyto-architectural features for the cytologic diagnosis of endometrial adenocarcinoma using parallel TP and SP preparations in a previous publication. STUDY DESIGN We performed our study on LM8 cells (a cultured osteosarcoma cell line). LM8 cells at a concentration of 1.25 × 10(3) cell/cm(2) were seeded on a 35-mm plate in culture medium, which contained 10% fetal bovine serum (FBS), 100 units/ml penicillin, and 100 μ/ml streptomycin in Dulbecco's modified Eagle's medium (DMEM), and aliquots of the cell suspension obtained in this way were compared after the addition of a hemolytic agent, i.e. Cytolyt® (CyL). LBC preparations were then obtained on cell suspensions treated with CyL after different time intervals of hemolysis. RESULTS Treatment with CyL did not alter the cellularity of the preparation, but reduction of the nuclear area and a tendency towards nuclear chromatin condensation with a subsequent higher brightness were found. Because CyL is a 25% methanol-buffered solution, its alcoholic concentration is low; it was our impression that, while its fixative effect was weak, its hemolytic effect was high. Water influx or efflux through the cell membrane is controlled by osmotic pressure changes induced by the buffer solution in the CyL solution. While CyL was not shown to alter the cell shape, nuclear shrinkage was thought to be probably due to the increasing cell dehydration caused by longer exposure intervals to methanol. CONCLUSION This study has allowed us to make significant observations on the hemolytic properties of CyL, and on its combined effects with PreservCyt on the cytomorphology of cells suspensions.
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Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Ehime, Japan
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22
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Yanoh K, Norimatsu Y, Munakata S, Yamamoto T, Nakamura Y, Murata T, Kobayashi TK, Hirai Y. Evaluation of endometrial cytology prepared with the Becton Dickinson SurePath™ method: a pilot study by the Osaki Study Group. Acta Cytol 2014; 58:153-61. [PMID: 24503811 DOI: 10.1159/000357769] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 11/29/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the sensitivity and specificity of the BD SurePath™ liquid-based Papanicolaou test for assessing the cytology of intrauterine endometrial samples according to newly devised cytological diagnostic criteria and a novel descriptive reporting format. MATERIALS AND METHODS One hundred and twenty-two endometrial samples were analyzed. All samples were obtained directly from the intrauterine cavity using the Uterobrush or Honest Super Brush. The samples used for the histological examination and cytological tests were collected simultaneously. Our study group devised new cytological diagnostic criteria for examining endometrial samples: the Osaki Study Group method. In this study, histological diagnosis was considered to be the gold standard for cytological diagnosis. A novel descriptive reporting format was also used. RESULTS Satisfactory cytological specimens were obtained in all cases. The sensitivity and specificity of the SurePath endometrial cytological examination method were 96.4 and 100%, respectively. CONCLUSION These results indicate that the SurePath method is acceptable for clinical use. Since the SurePath method seems to be easier and allows greater preparation standardization than the conventional method, coupling it with our newly devised cytological diagnostic criteria and descriptive reporting format might represent a reliable diagnostic method for assessing endometrial specimens.
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Affiliation(s)
- Kenji Yanoh
- Department of Obstetrics and Gynecology, JA Suzuka General Hospital, Suzuka, Japan
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23
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Ohsaki H, Shigematsu Y, Irino S, Hirakawa E, Norimatsu Y. Comparison of two liquid preservatives for SurePath™ slides prepared from voided urine. Diagn Cytopathol 2013; 42:423-7. [DOI: 10.1002/dc.23061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 09/05/2013] [Accepted: 10/10/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Hiroyuki Ohsaki
- Department of Medical Technology; Ehime Prefectural University of Health Sciences; Ehime Japan
| | - Yumie Shigematsu
- Department of Clinical Laboratory; Shigei Hospital; Okayama Japan
| | - Satoshi Irino
- Department of Nursing; Ehime Prefectural University of Health Sciences; Ehime Japan
| | - Eiichiro Hirakawa
- Laboratory of Pathology; Department of Medical Technology; Kagawa Prefectural University of Health Sciences; Japan
| | - Yoshiaki Norimatsu
- Department of Medical Technology; Ehime Prefectural University of Health Sciences; Ehime Japan
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24
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Kawanishi N, Norimatsu Y, Ohsaki H, Yuminamochi T, Katoh R, Okusaki K, Sato Y, Kobayashi TK. Diagnosis of pseudopapillary variant of medullary thyroid carcinoma by fine-needle aspiration cytology. Diagn Cytopathol 2013; 42:823-6. [PMID: 23894022 DOI: 10.1002/dc.23020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 05/01/2013] [Accepted: 05/15/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Namiki Kawanishi
- Department of Clinical Laboratory, Mihara Medical Associations Hospital, Hiroshima, Japan
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Norimatsu Y, Sakamoto S, Ohsaki H, Ozaki S, Yokoyama T, Shimizu K, Yanoh K, Akiyama M, Bamba M, Kobayashi TK. Cytologic features of the endometrial adenocarcinoma: Comparison of ThinPrep and BD surepath preparations. Diagn Cytopathol 2013; 41:673-81. [DOI: 10.1002/dc.22921] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 08/03/2012] [Indexed: 11/09/2022]
Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology; Ehime Prefectural University of Health Sciences; Ehime; Japan
| | - Shingo Sakamoto
- Department of Pathology; Matsuyama Red Cross Hospital; Ehime; Japan
| | - Hiroyuki Ohsaki
- Department of Medical Technology; Ehime Prefectural University of Health Sciences; Ehime; Japan
| | - Satoru Ozaki
- Department of Pathology; Kanazawa University Hospital; Ishikawa; Japan
| | - Toshiro Yokoyama
- Department of Pathology; Kurume University Medical Center; Fukuoka; Japan
| | - Keiko Shimizu
- Department of Pathology; Saiseikai Noe Hospital; Imperial Gift Foundation Inc.; Osaka; Japan
| | - Kenji Yanoh
- Department of Gynaecology; Suzuka General Hospital; Mie; Japan
| | - Minoru Akiyama
- Department of Obstetrics and Gynecology; Saiseikai Shiga Hospital; Imperial Gift Foundation Inc.; Shiga; Japan
| | - Masamichi Bamba
- Department of Pathology; Saiseikai Shiga Hospital; Imperial Gift Foundation Inc.; Shiga; Japan
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Norimatsu Y, Yanoh K, Kobayashi TK. The role of liquid-based preparation in the evaluation of endometrial cytology. Acta Cytol 2013; 57:423-35. [PMID: 24021666 DOI: 10.1159/000353148] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 05/09/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Liquid-based preparation (LBP) of the endometrial lesions is an important diagnostic tool for a variety of endometrial abnormalities because of its simplicity and high quali-quantitative diagnostic yield. We aimed to investigate the LBP method for endometrial cytology to evaluate both benign and abnormal endometrial lesions. STUDY DESIGN LBP is a semiautomated methodology that has recently become widely available and has gained popularity as a method of collecting and processing both gynecologic and nongynecologic cellular specimens. RESULTS Some peculiar endometrial cytoarchitectural features were described using LBPs. These were advantageous to screen as compared to conventional slides due to a smaller screening area and an excellent quality of cell preparations. CONCLUSIONS LBP is a useful tool in the cellular diagnosis and follow-up of endometrial abnormalities, which remains complementary to the emerging molecular diagnostic cytopathology. The study of LBPs from endometrial cytology could be challenging since it is affected by numerous look-alikes and diagnostic pitfalls. This review discusses these various entities and takes into consideration the ancillary techniques that may be useful in the diagnostic procedure.
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Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Tobe, Japan
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Yanoh K, Hirai Y, Sakamoto A, Aoki D, Moriya T, Hiura M, Yamawaki T, Shimizu K, Nakayama H, Sasaki H, Tabata T, Ueda M, Udagawa Y, Norimatsu Y. Authors' reply. Acta Cytol 2013; 57:114. [PMID: 23397637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Nakamura A, Aizawa J, Sakayama K, Kidani T, Takata T, Norimatsu Y, Miura H, Masuno H. Genistein inhibits cell invasion and motility by inducing cell differentiation in murine osteosarcoma cell line LM8. BMC Cell Biol 2012; 13:24. [PMID: 23013480 PMCID: PMC3515800 DOI: 10.1186/1471-2121-13-24] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 09/20/2012] [Indexed: 01/25/2023] Open
Abstract
Background One of the problems associated with osteosarcoma is the frequent formation of micrometastases in the lung prior to diagnosis because the development of metastatic lesions often causes a fatal outcome. Therefore, the prevention of pulmonary metastases during the early stage of tumor development is critical for the improvement of the prognosis of osteosarcoma patients. In Japan, soy is consumed in a wide variety of forms, such as miso soup and soy sauce. The purpose of this study is to investigate the effect of genistein, an isoflavone found in soy, on the invasive and motile potential of osteosarcoma cells. Methods LM8 cells were treated for 3 days with various concentrations of genistein. The effect of genistein on cell proliferation was determined by DNA measurement in the cultures and 5-bromo-2’-deoxyuridine (BrdU) incorporation study. The assays of cell invasion and motility were performed using the cell culture inserts with either matrigel-coated membranes or uncoated membranes in the invasion chambers. The expression and secretion of MMP-2 were determined by immunohistochemistry and gelatin zymography. The subcellular localization and cellular level of β-catenin were determined by immunofluorescence and Western blot. For examining cell morphology, the ethanol-fixed cells were stained with hematoxylin-eosin (H&E). The expression of osteocalcin mRNA was determined by reverse transcription-polymerase chain reaction (RT-PCR). Results Genistein dose-dependently inhibits cell proliferation. Genistein-treated cells were less invasive and less motile than untreated cells. The expression and secretion of MMP-2 were lower in the genistein-treated cultures than in the untreated cultures. β-Catenin in untreated cells was located in the cytoplasm and/or nucleus, while in genistein-treated cells it was translocated near to the plasma membrane. The level of β-catenin was higher in genistein-treated cells than in untreated cells. Treatment of LM8 cells with genistein induced morphological changes, markedly decreased the formation of multilayer masses of cells, and markedly increased the expression of osteocalcin mRNA. Conclusions Genistein decreased invasive and motile potential by inducing cell differentiation in LM8 cells. Genistein may be useful as an anti-metastatic drug for osteosarcoma through its differentiation-inducing effects.
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Affiliation(s)
- Atsushi Nakamura
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Takooda, Tobe-cho, Iyo-gun, Ehime, 791-2101, Japan
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Norimatsu Y, Kawai M, Kamimori A, Yuminamochi T, Ohsaki H, Yanoh K, Kawanishi N, Kobayashi TK. Endometrial glandular and stromal breakdown, Part 4: Cytomorphology of "condensed cluster of stromal cells including a light green body". Diagn Cytopathol 2012; 40:204-9. [PMID: 22334522 DOI: 10.1002/dc.21532] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Accepted: 07/30/2010] [Indexed: 11/08/2022]
Abstract
This study was undertaken to clarify the origin of the chromophilic substance that stained in light green [light green body (LGB)] was observed in the condensed cluster of stromal cells and in the background of endometrial glandular and stromal breakdown cases. The material consists of cytologic smears of endometrial glandular and stromal breakdown (EGBD) from 58 samples in which a histopathological diagnosis was subsequently obtained by endometrial curettage. The following parameters were examined. (1) The occurrence and number of a LGB. As for the "condensed cluster of stromal cells," "condensed cluster of stromal cells including LGB" and "LBG in background," it was observed with all fields on one slide per case. When it was observed more than one in a preparation, the occurrence was determined and the number was also calculated. (2) Immunostaining of paraffin-embedded tissue sections and cytologic preparations. 1 The occurrence of "condensed cluster of stromal cells," "condensed cluster of stromal cells including LGB" and "LGB in background" was 100%, 44.8% and 91.4%, respectively. The number of "condensed cluster of stromal cells," "condensed cluster of stromal cells including LGB" and "LGB in background" was 21.2, 2.0 and 4.0, respectively. 2 When histological sections from paraffin-embedded tissue were tested by immunocytochemistry, "LGB" stained weakly or negative for fibrinogen, whereas it stained positively for CD31 and factor VIII. In addition, it stained positively for CD42b. 3 When cytologic preparation was tested by immunocytochemistry, "LGB" stained positively for CD31, factor VIII and CD42b. However, as for the fibrinogen, quantitative and qualitative evaluation of the immunocytochemical stain was not feasible due to extensive nonspecific reaction in the whole preparation. The "LGB" in EGBD cases proved to be a thrombus mostly made up by platelets, and it seemed that the recognition of the LGB showed to be a useful cytomorphological criterion for an always more accurate diagnosis of EGBD cases.
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Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Ehime, Japan
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Ohsaki H, Hirouchi T, Hayashi N, Okanoue E, Ohara M, Kuroda N, Hirakawa E, Norimatsu Y. Diagnostic value of urine erythrocyte morphology in the detection of glomerular disease in SurePath™ liquid-based cytology compared with fresh urine sediment examination. Cytopathology 2012; 24:52-7. [DOI: 10.1111/j.1365-2303.2012.00958.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ohsaki H, Nakamura M, Arie K, Hirakawa E, Haba R, Norimatsu Y. Endometriosis of sigmoid colon mimicking malignant tumor diagnosed by intraoperative imprint cytology. Diagn Cytopathol 2012; 40:159-62. [PMID: 22246934 DOI: 10.1002/dc.21608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 10/21/2010] [Indexed: 01/06/2023]
Abstract
A case of endometriosis of the sigmoid colon on imprint cytology from an intraoperative biopsy is discussed. Cytologic specimens showed sheets or tubular epithelial clusters and stromal fragments. The epithelial cell nuclei were small and round to ovoid with finely granular chromatin and inconspicuous nucleoli. The background showed a few scattered spindle-type stromal cells without pigment-laden histiocytes. A definitive diagnosis of endometriosis can be based on cytology, provided that the cytologic findings are interpreted in the appropriate clinical context.
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Affiliation(s)
- Hiroyuki Ohsaki
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Ehime, Japan.
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Norimatsu Y, Shigematsu Y, Sakamoto S, Ohsaki H, Yanoh K, Kawanishi N, Kobayashi TK. Nuclear features in endometrial cytology: Comparison of endometrial glandular and stromal breakdown and endometrioid adenocarcinoma grade 1. Diagn Cytopathol 2012; 40:1077-82. [DOI: 10.1002/dc.21738] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 04/11/2011] [Indexed: 11/06/2022]
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Yanoh K, Hirai Y, Sakamoto A, Aoki D, Moriya T, Hiura M, Yamawaki T, Shimizu K, Nakayama H, Sasaki H, Tabata T, Ueda M, Udagawa Y, Norimatsu Y. New terminology for intrauterine endometrial samples: a group study by the Japanese Society of Clinical Cytology. Acta Cytol 2012; 56:233-41. [PMID: 22555523 DOI: 10.1159/000336258] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 01/04/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the sensitivity and specificity of endometrial cytology obtained by intrauterine sample using a descriptive reporting format for endometrial cytological diagnosis. STUDY DESIGN 10,152 consecutive endometrial scrapings obtained in 13 different Japanese hospitals were analyzed. Cytological results were classified as 'negative for malignancy', 'atypical endometrial cells' (ATEC), 'endometrial hyperplasia', 'atypical endometrial hyperplasia' or 'malignant tumor'. ATEC was subclassified as 'ATEC, of undetermined significance' (ATEC-US) and 'ATEC, cannot exclude atypical endometrial hyperplasia or more' (ATEC-A). Cytological results were compared with the histological diagnosis as a gold standard. When the cytological result was 'negative for malignancy' and there was no subsequent histological examination, the case was considered a true negative when the endometrium was assessed as normal on transvaginal ultrasonography and there was no abnormal uterine bleeding. RESULTS 1,083 cases in which histology was not performed, 557 cases of 'unsatisfactory specimen' and 76 cases of ATEC-US were excluded. In the remaining 8,436 cases, the sensitivity and specificity, positive predictive value and negative predictive value for detecting atypical endometrial hyperplasia or malignant tumors were 79.0 and 99.7, 92.9 and 98.9%, respectively. CONCLUSION The current diagnostic standards for endometrial cytology in Japan were established. Specificity is satisfactory for excluding cancer or precancerous diseases.
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Affiliation(s)
- Kenji Yanoh
- Department of Obstetrics and Gynecology, JA Suzuka General Hospital, Suzuka, Japan.
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Norimatsu Y, Ohsaki H, Yanoh K, Kawanishi N, Kobayashi TK. Expression of immunoreactivity of nuclear findings by p53 and cyclin a in endometrial cytology: Comparison with endometrial glandular and stromal breakdown and endometrioid adenocarcinoma grade 1. Diagn Cytopathol 2011; 41:303-7. [DOI: 10.1002/dc.21837] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 08/11/2011] [Indexed: 11/06/2022]
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Norimatsu Y, Shigematsu Y, Sakamoto S, Ohsaki H, Yanoh K, Kawanishi N, Kobayashi TK. Nuclear characteristics of the endometrial cytology: Liquid-based versus conventional preparation. Diagn Cytopathol 2011; 41:120-5. [PMID: 23335453 DOI: 10.1002/dc.21784] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 06/22/2011] [Indexed: 11/08/2022]
Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Ehime, Japan
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Norimatsu Y, Tsueda J, Hirata A, Iwasawa S, Toyoshima C. Visualization of lipid bilayers in protein crystals by contrast modulation. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311081347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Norimatsu Y, Kawanishi N, Shigematsu Y, Kawabe T, Ohsaki H, Kobayashi TK. Use of liquid-based preparations in urine cytology: An evaluation of Liqui-PREP and BD SurePath. Diagn Cytopathol 2010; 38:702-4. [PMID: 19950401 DOI: 10.1002/dc.21279] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Kawanishi N, Norimatsu Y, Funakoshi M, Kamei T, Sonobe H, Kawano R, Kobayashi TK. Fine needle aspiration cytology of solid neuroendocrine carcinoma of the breast: a case report. Diagn Cytopathol 2010; 39:527-30. [PMID: 21695806 DOI: 10.1002/dc.21494] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Accepted: 06/10/2010] [Indexed: 11/08/2022]
Abstract
We report a case of neuroendcrine (NE) carcinoma in the right breast of a 67-year-old female, ultrasonography revealed a lesion composed of irregular hypoechoic masses and mammography showed asymmetric breast tissue. Histopathologic examination of the surgical sample showed a solid to nested proliferation of plasmacytoid cells that showed immunocytochemical positivity for chromogranin A, synaptophysin, CD56, and estrogen receptor. Our case was diagnosed as solid NE carcinoma. Though the findings of fine needle aspiration cytology reflected the histological features, we were not able to cytopathologic grounds only to predict the NE nature of this tumor. We performed immunocytochemistry using Chromogranin A, Synaptophysin, and CD56 on our cytologic smear retrospectively with positive results for all of the markers. When the cytopathologic examination of a given breast neoplasm is suggestive of NE differentiation, immunocytochemical staining for NE markers is generally useful for a correct preoperative diagnosis. An acurate preoperative diagnosis of NE carcinoma on FNAC can be achieved based on its distinctive cytomorphologic and immunocytochemical features.
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Affiliation(s)
- Namiki Kawanishi
- Department of Clinical Laboratory, Mihara Medical Associations Hospital, Hiroshima, Japan
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Ohsaki H, Hirakawa E, Nakamura M, Norimatsu Y, Kiyomoto H, Haba R. Expression of vimentin and high-molecular-weight cytokeratin (clone 34ßE12) in differentiating reactive renal tubular cells from low-grade urothelial carcinoma cells in voided urine. Cytopathology 2010; 22:247-52. [PMID: 20653719 DOI: 10.1111/j.1365-2303.2010.00791.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Reactive renal tubular cells show features of an atypical repair reaction. Differentiation between reactive renal tubular cells and low-grade urothelial carcinoma (LG-UC) cells can therefore be a diagnostic challenge based on morphology alone. In this study, we evaluated the diagnostic utility of vimentin and a high-molecular-weight cytokeratin antibody (clone 34ßE12) in differentiating reactive renal tubular cells from LG-UC. METHODS We evaluated voided urine cytology and surgical specimens from 40 patients with renal disease, and 17 patients with LG-UC. All slides were stained with vimentin and 34ßE12. RESULTS In the reactive renal tubular cells in voided urine cytology, vimentin showed strong cytoplasmic staining in 39/40 (97.5%) cases, but all were negative for 34ßE12. LG-UC cells showed positive staining for 34ßE12 in 3/17 (17.6%) cases, whereas none were positivity for vimentin. The reactive renal tubular cells of histological specimens in the renal disease group demonstrated positive for vimentin in all 40 cases and all were negative for 34ßE12. The LG-UC group showed abnormal staining for 34ßE12 in 4/17 (23.5%) cases, whereas none were positive for vimentin. CONCLUSIONS Vimentin expression in urine cytology can help to distinguish reactive renal tubular cells from LG-UC. However, 34ßE12 does not appear to be a useful adjunct to distinguish these two groups in voided urine cytology.
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Affiliation(s)
- H Ohsaki
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Ehime, Japan.
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Aizawa J, Sakayama K, Kamei S, Kidani T, Yamamoto H, Norimatsu Y, Masuno H. Effect of troglitazone on tumor growth and pulmonary metastasis development of the mouse osteosarcoma cell line LM8. BMC Cancer 2010; 10:51. [PMID: 20170548 PMCID: PMC2838820 DOI: 10.1186/1471-2407-10-51] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 02/22/2010] [Indexed: 01/31/2023] Open
Abstract
Background Osteosarcoma often develops micrometastases in the lung prior to diagnosis, causing a fatal outcome. Therefore, the prevention of pulmonary metastases is critical for the improvement of the prognosis of patients with osteosarcoma. The purpose of this study was to investigate whether troglitazone (TGZ) is considered as possible therapeutics in the treatment of growth and metastasis of osteosarcoma. Methods LM8 cells were treated for 3 days with various concentrations of TGZ. The effect of TGZ on cell proliferation was determined by DNA measurement in the cultures and 5-bromo-2'-deoxyuridine incorporation study. The assay of cell invasion and motility was performed using either the Matrigel-coated cell culture inserts or the uncoated cell culture inserts in the invasion chambers. The effect of TGZ on Akt signaling was assessed by Western blot analysis of Akt and p-Akt. The effects of oral administration of either TGZ (TGZ group) or ethanol (control group) on the growth of primary tumor and the development of pulmonary metastasis were examined in nude mice implanted with LM8 cells on their backs. The expression and activity of matrix metalloproteinase 2 (MMP-2) within the tumor were determined by immunohistochemistry and zymography. The microvessel density (MVD) within the tumor was determined by immunohistochemistry for CD34. Results TGZ dose-dependently inhibits cell proliferation. TGZ-treated cells were less invasive and less motile than untreated cells. The activity of MMP-2 secreted by TGZ-treated cells was lower than that secreted by untreated cells. TGZ decreased the level of p-Akt. The primary tumor mass was smaller in the TGZ group than in the control group. The TGZ group had less metastatic tumors in the lung compared with the control group. The expression and activity of MMP-2 within the tumor of the TGZ group were lower than those of the control group. The MVD within the tumor of the TGZ group was lower than that of the control group. Conclusions Inhibition of Akt signaling by TGZ may decrease the secretion of MMP-2, resulting in the decrease of invasiveness and motility in LM8 cells. Treatment of tumor-bearing mice with TGZ decreases the expression and activity of MMP-2 within the tumor, and inhibits primary tumor growth and pulmonary metastasis development. TGZ may offer a new approach in chemotherapy for osteosarcoma.
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Affiliation(s)
- Junichi Aizawa
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Takooda, Tobe-cho, Iyo-gun, Ehime 791-2101, Japan
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Norimatsu Y, Kouda H, Kobayashi TK, Shimizu K, Yanoh K, Tsukayama C, Miyake Y, Ohno E. Utility of liquid-based cytology in endometrial pathology: diagnosis of endometrial carcinoma. Cytopathology 2009; 20:395-402. [PMID: 19863617 DOI: 10.1111/j.1365-2303.2008.00589.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the utility of SurePath-liquid-based cytology (LBC) compared to conventional cytological preparations (CCP) in the identification of endometrial carcinoma. METHODS During a 13-month period, direct endometrial samples were collected from 120 patients using the Uterobrush. The material comprised 30 cases each of endometrial carcinoma, proliferative endometrium, secretory endometrium and atrophic endometrium. The following points were investigated:(i) the frequency of cell clumps in endometrial carcinoma; (ii) the area of cell nuclei; (iii) overlapping nuclei. RESULTS (i) Comparison of the frequency of cell clumps with irregular protrusion pattern and papillo-tubular pattern showed no statistically significant difference in either type of cell clump between CCP and LBC. (ii) Comparison of the nuclear area of cells showed a sequential decrease from endometrial carcinoma to secretory endometrium, to proliferative endometrium and to atrophic endometrium, which was significant in CCP and LBC. (iii) Nuclear area was significantly lower with LBC compared with CCP in endometrial carcinoma, secretory endometrium and proliferative endometrium but not atrophic endometrium. (iv) Comparison of the degree of overlapping nuclei showed a sequential decrease from endometrial carcinoma to proliferative endometrium, to secretory endometrium and to atrophic endometrium, which was significant in both CCP and LBC. (v) Comparison of the degree of overlapping nuclei between CCP and LBC showed no significant difference for normal types of endometrium, but LBC had significantly higher values (P < 0.0001) in endometrial carcinoma than in CCP. CONCLUSIONS The results of this study revealed that applying diagnostic criteria used in CCP to LBC was easy to achieve, because LBC had excellent cytoarchitectural preservation and cells were well presented. Although we have not examined all cytological features of malignancy and have not considered atypical hyperplasia, we believe that this method may be a useful tool in the diagnosis of endometrial cytology.
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Affiliation(s)
- Y Norimatsu
- Department of Pathology, Kurashiki Central Hospital, Kurashiki, Japan
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Norimatsu Y, Yuminamochi T, Shigematsu Y, Yanoh K, Ikemoto R, Masuno H, Murakami M, Kobayashi TK. Endometrial glandular and stromal breakdown, Part 3: Cytomorphology of “condensed cluster of stromal cells”. Diagn Cytopathol 2009; 37:891-6. [DOI: 10.1002/dc.21141] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Kamei S, Sakayama K, Tamashiro S, Aizawa J, Miyawaki J, Miyazaki T, Yamamoto H, Norimatsu Y, Masuno H. Ketoprofen in topical formulation decreases the matrix metalloproteinase-2 expression and pulmonary metastatic incidence in nude mice with osteosarcoma. J Orthop Res 2009; 27:909-15. [PMID: 19105229 DOI: 10.1002/jor.20832] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The aim of this study was to investigate whether ketoprofen (KP) in topical formulation affected the tumor growth and pulmonary metastasis of LM8 cells, which were inoculated subcutaneously into the back space of male nude mice. At 7 days after inoculation, the tumor was treated topically for 3 weeks with either a KP-containing patch (KP group) or a placebo-containing patch (placebo group). The pulmonary metastatic incidence was 100% in the placebo group and 60% in the KP group. The tumor mass of the KP group without pulmonary metastasis, termed the KP/metastasis(-) group, was smaller than that of the placebo group. Immunohistochemical staining for proliferating cell nuclear antigen (PCNA), terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL), matrix metalloproteinase-2 (MMP-2), and vascular endothelial growth factor (VEGF) was performed. The tumors of the KP/metastasis(-) group contained fewer PCNA-positive cells and many more TUNEL-positive cells in comparison to the placebo group. In the placebo group, MMP-2 and VEGF were extensively expressed within the tumor, whereas in the KP/metastasis(-) group the expression of these two proteins was very low. In conclusion, the topical treatment of osteosarcoma with KP decreased the expression of MMP-2 and VEGF, thus resulting in the suppression of tumor growth and pulmonary metastasis.
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Affiliation(s)
- Setsuya Kamei
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
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Shimizu K, Norimatsu Y, Kobayashi TK, Sakurai M, Ogura S, Yoshizawa A, Sakurai T, Miyamoto T, Miyake Y, Aratake Y, Sakaguchi T, Ohno E. Diagnostic value of endometrium associated with papillary metaplastic changes in endometrial cytopathology. Diagn Cytopathol 2009; 37:487-91. [DOI: 10.1002/dc.21030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Miyake Y, Hirokawa M, Norimatsu Y, Kanahara T, Monobe Y, Ohno S, Miyamoto T, Yakushiji H, Sakaguchi T, Aratake Y, Ohno E. Mucinous breast carcinoma with myoepithelial-like spindle cells. Diagn Cytopathol 2009; 37:393-6. [PMID: 19263486 DOI: 10.1002/dc.20983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Appearance of spindle cells has been believed as a benign index of breast cytology. But, we have frequently observed the spindle cells in smears from mucinous carcinoma of the breast. Here, we characterized the biochemical nature of the spindle cells, so as to clarify their identity in cytology. Nineteen cases of breast mucinous carcinoma were used for cytological examination. The spindle cells were located at edges of tumor cell nests and in the backgrounds of cytological specimens. Immunohistological examination revealed that the spindle cells exhibited both immunoreactivity against carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA). Immunoreactivity against vimentin, cytokeratin, or alpha-smooth muscle actin was, however, not observed. The mode of distribution of biochemical markers suggests that the positive cells for anti-CEA antibody and anti-EMA antibody are tumor cells compressed by mucin, while the vimentin-positive cells are fibroblasts. We assert that the presence of spindle cells can be a characteristic feature of mucinous carcinoma of the breast. Discrimination of the spindle cells in mucinous carcinoma from myoepithelial cells and naked bipolar nuclei in benign lesions was established here. It should facilitate precise diagnosis of breast cancer.
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Affiliation(s)
- Yasuyuki Miyake
- Department of Medical Life Science, Kurashiki University of Science and the Arts, Okayama, Japan.
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Shimizu K, Norimatsu Y, Kobayashi TK, Sakurai M, Ogura S, Yoshizawa A, Miyamoto T, Miyake Y, Aratake Y, Sakaguchi T, Ohno E. Expression of immunoreactivity and genetic mutation in eosinophilic and ciliated metaplastic changes of endometrial glandular and stromal breakdown: cytodiagnostic implications. Ann Diagn Pathol 2009; 13:89-95. [DOI: 10.1016/j.anndiagpath.2008.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yanoh K, Norimatsu Y, Hirai Y, Takeshima N, Kamimori A, Nakamura Y, Shimizu K, Kobayashi TK, Murata T, Shiraishi T. New diagnostic reporting format for endometrial cytology based on cytoarchitectural criteria. Cytopathology 2008; 20:388-94. [PMID: 18657157 PMCID: PMC2788060 DOI: 10.1111/j.1365-2303.2008.00581.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to develop a new reporting format for endometrial cytology that would standardize the diagnostic criteria and the terminology used for reporting. METHODS In previous studies, cytoarchitectural criteria were found to be useful for the cytological assessment of endometrial lesions. To apply these criteria, an appropriate cytological specimen is imperative. In this article, the requirements of an adequate endometrial cytological specimen for the new diagnostic criteria are first discussed. Then, the diagnostic criteria, standardized on a combination of conventional and cytoarchitectural criteria, are presented. Third, terminology that could be used, not only for reporting the histopathological diagnosis, but also for providing better guidance for the gynaecologist to determine further clinical action, is introduced. The proposed reporting format was investigated using endometrial cytology of 58 cases that were cytologically underestimated or overestimated compared to the histopathological diagnosis made on the subsequent endometrial biopsy or surgical specimens. RESULTS Of the 58 cases, 12 were reassessed as being unsatisfactory for evaluation. Among the remaining 46 cases, 25 of the 27 cases, which had been underestimated and subsequently diagnosed as having endometrial carcinoma or a precursor stage on histopathological examination,were reassessed as recommended for endometrial biopsy. On the other hand, 19 cases overestimated by cytology were all reassessed as not requiring biopsy. CONCLUSIONS The reporting format for endometrial cytology proposed in this article may improve diagnostic accuracy and reduce the number of patients managed inappropriately.
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Affiliation(s)
- K Yanoh
- Department of Gynaecology, Suzuka General Hospital, Mie 513-8630, Japan.
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Norimatsu Y, Miyamoto M, Kobayashi TK, Moriya T, Shimizu K, Yanoh K, Tsukayama C, Miyake Y, Ohno E. Diagnostic utility of phosphatase and tensin homolog, β-catenin, and p53 for endometrial carcinoma by thin-layer endometrial preparations. Cancer 2008; 114:155-64. [DOI: 10.1002/cncr.23495] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Norimatsu Y, Kouda H, Kobayashi TK, Moriya T, Yanoh K, Tsukayama C, Miyake Y, Ohno E. Utility of thin-layer preparations in the endometrial cytology. Ann Diagn Pathol 2008; 12:103-11. [DOI: 10.1016/j.anndiagpath.2007.05.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Norimatsu Y, Miyamoto T, Kobayashi TK, Oda T, Moriya T, Yanoh K, Miyake Y, Ohno E. Utility of thin-layer preparations in endometrial cytology: Immunocytochemical expression of PTEN, beta-catenin and p53 for benign endometrial lesions. Diagn Cytopathol 2008; 36:216-23. [DOI: 10.1002/dc.20795] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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