A. Bolte

Detection of squamous cell carcinoma antigen in normal squamous epithelia and in squamous cell carcinomas of the uterine cervix.

Squamous cell carcinoma (SCC) antigen is a subfraction of tumor antigen TA‐4 isolated from a cervical squamous cell carcinoma. The specificity of SCC antigen and the factors influencing its release into serum were evaluated. Antigen concentrations were measured in 157 tissue extracts and in 188 sera of patients with nonmalignant or malignant gynecologic diseases. A commercial radioimmunoassay based on polyclonal antibodies (Abbott Laboratories, North Chicago) was used. Cytosol concentrations were significantly higher (P < 0.005) in normal squamous epithelia (x̃ = 6040 ng/mg cell protein [CP]) and in squamous cell carcinomas (x̃ = 2483 ng/mg CP) of the exocervix than those in normal columnar epithelia and in adenocarcinomas of the endocervix, endometrium, ovary, and breast (x̃ = 1–508 ng/mg CP). Despite the high antigen concentrations in normal squamous epithelia, elevated serum levels (>2.5 ng/ml) were almost exclusively found in patients with cervical squamous cell carcinomas. The sensitivity of SCC antigen as a marker for primary carcinomas was 61%, increasing from 29% in Stage I to 89% in Stage IV. The positivity rate was higher in women with well‐differentiated (78%) and moderately differentiated carcinomas (67%) than in those with poorly differentiated tumors (38%). The results show that SCC antigen is not tumor specific. The release into serum is independent of local tissue content, but is apparently influenced by the infiltrative growth, the mass, and the degree of histologic differentiation of the tumor.

Immunohistochemical study of distribution of estrogen receptors in corpus and cervix uteri

SummaryAn immunohistochemical assay based on monoclonal antiestrophilin antibodies has been used to localize estrogen receptor (ER) in frozen sections of normal human endometrial, myometrial and cervical tissues from menstruating, hormonally treated, pregnant and postmenopausal women. Specific staining was confined to the cellular nuclei. In proliferative phase endometrium, postmenopausal emdometrium, and endometrium from patients treated with hormone ERs were easily detected in most glandular and stromal cells. After ovulation and in early pregnancy a quick and distinct decrease of ER expression was noted. This was especially the case with the more superficial layers of endometrium (endometrium functionals), the majority of whose cells had either weak localization of ER or none at all. In the endometrium basalis, however, the reduction of ER localization turned out to be more moderate. More then half of the epithelial and stromal cells displayed nuclear staining, partly strong. The myometrium of the corpus uteri showed a similar ER localization and dependence on hormonal stage when compared with the endometrium functionalis. The endocervical mucosa displayed a high degree of ER expression in the proliferative phase in postmenopausal women and in women who had been treated with hormones. Unlike the endometrium and myometrium, the endocervical glands underwent minimal changes in nuclear ER content during the menstrual cycle. Although the endocervical stroma showed cyclic alterations in ER levels, their reduction after ovulation was less marked than in the corresponding endometria. In cervical squamous epithelium ER localization was predominantly confined to the basal layers. In the course of cellular maturation, specific nuclear staining vanished. In the proliferative phase, after the menopause and in early pregnancy, the basal, parabasal and intermediate cells were specifically stained. In the postovulatory phase. However, nuclear staining was confined to the basal and parabasal cells. Hormonally treated squamous epithelia almost completely lacked nuclear ER localization.

Relationship between amniotic fluid insulin and maternal blood glucose concentrations in patients with carbohydrate intolerance during pregnancy

In contrast to maternal blood glucose, amniotic fluid insulin (AFI) directly reflects the functional state of the fetal pancreas. In a prospective study we evaluated the correlation of AFI with maternal metabolic control in 70 amniotic fluid specimens from 61 women having carbohydrate intolerance during pregnancy (White A n = 44, B0 n = 17). AFI was measured with the Insulin RIA 100 kit from Pharmacia (Freiburg). The normal range of AFI was established in 304 healthy pregnant women (16th-42nd gestational week). AFI concentrations increased by a factor of 1.5 to 2 during gestation reflecting the maturation of the fetal pancreas. Elevated AFI levels (> 97th centile) were found in 11% of normoglycemic diabetics and in 50% of women with insufficient metabolic control. Despite a high overall concordance (81%) no direct relationship could be found between fetal and maternal parameters. Patients with increased AFI values had a 5-fold higher rate of large-for-gestational age (LGA) infants than women with normal levels. This finding confirms the pathogenetic role of hyperinsulinism in the development of fetal macrosomia.

Vorkommen der tumorassoziierten Antigene CA 50 und CA 19-9 in Endometriumkarzinomen

CA 50 und CA 19-9 konnen immunhistochemisch an routinemasig fixierten und in Paraffin eingebetteten Geweben bestimmt werden und zeigen eine Expression in ¾ aller Endometriumkarzinome. Eine deutlich hohere Inzidenz findet sich in besser differenzierten Karzinomen.

Die Expression des epidermal growth factor (EGF), seines Rezeptors (EGF-R) und des Onkogens c-erb B 2 im primären Mammakarzinom

Zahlreiche autokrine Wachstumsfaktoren und ihre Rezeptoren weisen grose Sequenzhomologien zu Onkogenen auf, denen eine wichtige Rolle bei der malignen Transformation von Zellen zugesprochen wird. Die Wirkung des epidermal growth factor (EGF), einem potenten Mitogens fur das Brustdrusengewebe, wird uber seinen Rezeptor (EGF-R) vermittelt. Die Expression des EGF-R und des vom strukturahnlichen c-erb B2 kodierten Proteins (p185) scheint im Mammakarzinom vermehrt. Dies soll Ausdruck einer ungunstigen Prognose sein.

Immunhistochemische Lokalisation des Östrogenrezeptors am Uterus

Ffille ohne gr6f3ere Anteile von Nichtkarzinom mit ER-DCC zuverlfissig auszuwerten, da Stroma und Myometrium auch bei rezeptornegativem Karzinom positiv reagieren; diese Differenzierung gelingt jedoch nur mit dem ER-ICA-Verfahren. Somit liefert der immunzytochemische Nachweis des Ostrogenrezeptors mit hoher Zuverlfissigkeit dieselben Aussagen wie die Zytosolanalyse beim Mammakarzinom, erm6glicht eine genauere Beurteilung beim Endometriumkarzinom. ER-ICA kann auch bei so kleinen Gewebeproben durchgefiihrt werden, dab sie fiir ER-DCC nicht ausreichen. Transport und Aufbewahrung sind ftir beide Verfahren gleich (Notwendigkeit einer Ktihlkette, Einfrieren in fltissigem Stickstoff und Aufbewahren bei -80 ~ Laboraufwand und Zeitbedarf sind ftir ER-ICA geringer.