Prognostic significance of combined conventional and immunocytochemical cytology for peritoneal washings in endometrial carcinoma

Citation
Ml. Luo et al., Prognostic significance of combined conventional and immunocytochemical cytology for peritoneal washings in endometrial carcinoma, CANC CYTOP, 93(2), 2001, pp. 115-123
Citations number
26
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
CANCER CYTOPATHOLOGY
ISSN journal
0008-543X → ACNP
Volume
93
Issue
2
Year of publication
2001
Pages
115 - 123
Database
ISI
SICI code
0008-543X(20010425)93:2<115:PSOCCA>2.0.ZU;2-R
Abstract
BACKGROUND. Noncancerous cells simulating adenocarcinoma cells may interfer e with the analysis of peritoneal cytology (PC) in patients with endometria l carcinoma. Immunocytochemistry (ICC) may improve the diagnosis of PC. METHODS, PC slides from 115 patients with endometrial carcinoma were review ed. Suspicious or positive cell clusters were recovered with a cell transfe r method and were subjected to ICC for MOC-31, cytokeratin 5/6, and p53. Co nventional Papanicolaou staining and ICC results were compared directly on the same cells. RESULTS. By combined conventional and immunocytochemical PC (CONV-ICC-PC), cytodiagnosis was positive in 18 of 115 patients (15.7%) and suspicious in 3 of 115 patients (2.6%). According to a multivariate Cox regression analys is of patients with tumors confined to the uterus that included grade, myom etrial invasion, cervical involvement, and CONV-ICC-PC, only CONV-ICC-PC wa s an independent prognostic factor (P < 0.05). A multivariate analysis for all of the patients studied that compared CONV-ICC-PC with staging variable s revealed that only peritoneal metastasis (P < 0.0001) and lymph node meta stasis (P < 0.01) were independent prognostic factors. When peritoneal meta stases were excluded, CONV-ICC-PC (P < 0.01) and lymph node metastasis (P < 0.0025) were the independent prognostic factors. By cell transfer and p53 immunostaining in samples from 14 patients with malignant cells in their pe ritoneal washings, no deaths occurred among 5 patients with negative p53, w hereas 5 of 9 patients with positive p53 died of disease at the time of dat a analysis. CONCLUSIONS, MOC-31 immunostaining improves the diagnosis of PC in endometr ial carcinoma. Positive PC is an important prognostic factor for patients w ith endometrial carcinoma confined to the uterus. The p53 positive cells in PC have possible prognostic significance. Cancer (Cancer Cytopathol) 2001; 93:115-123, (C) 2001 American Cancer Society.