Junko Saito

Expression of blood group Antigens A, B, H, Lewis-a, and Lewis-b in fetal, normal, and malignant tissues of the uterine endometrium

Fetal, normal adult, and malignant tissues of the uterine endometrium were examined by immunoperoxidase staining for the blood group antigens (BGA) A, B, H, Lewis‐a, and Lewis‐b. Antigens A, B, and H compatible with the ABO status of fetuses were detected in 20 of the 22 fetal tissues that were examined. Lewis‐b immunoreactivity was also found in 21 fetuses, and Lewis‐a was present in a third of the cases. In adult endometrium the expression of BGA H and Lewis‐b was considerably lower than in fetal tissues. Malignant endometrial glands extensively reexpressed H and Lewis‐b regardless of ABO status. BGA A and B were neither absent nor accumulated in cancer tissues. Thus, H and Lewis‐b can be considered as oncofetal antigens since they were frequently expressed in fetal and cancer tissues, but not in normal adult tissues. The increased expression of Lewis‐a antigen might be associated with malignant transformation as it was observed only in malignant tissues. However, the functional significance of alterations in BGA expression that may be associated with oncogenesis remains to be investigated.

Immunohistochemical Demonstration of Tumor Antigen Ta-4 in Gynecologic Tumors

Tumor antigen TA-4, raised against human cervical squamous cell carcinoma, was studied by an immunoperoxidase method in various gynecologic tumors. TA-4 was detected invariably in normal differentiated cervical squamous cells. It was also found infrequently in normal glandular cells of the cervix, but not in the endometrium. In squamous cell carcinomas of the cervix, TA-4 was positive in the differentiated cells regardless of invasiveness or histological type. It was demonstrated in some adenocarcinomas of the cervix, and less frequently in those of the endometrium. In ovarian tumors, TA-4 was localized occasionally in a variable number of glandular tumor cells of serous, mucinous, endometrioid, and clear cell carcinomas. Only a few transitional cells contained TA-4 in a Brenner tumor. Squamous components of ovarian tumors, both benign and malignant, were frequently positive for TA-4.

An immunohistochemical study of small-cell and poorly differentiated carcinomas of the cervix using neuroendocrine markers

Small-cell and poorly differentiated carcinomas of the cervix were studied immunohistochemically for several neuroendocrine and epithelial markers. Neuroendocrine markers were frequently expressed in small-cell carcinomas with argyrophilia; of the seven such tumors, four were immunoreactive with anti-chromogranin, seven with antineuroendocrine, five with anti-Leu 7, and seven with anti-neuron-specific enolase. Only neuron-specific enolase, however, was expressed in two of the three small-cell carcinomas without argyrophilia. On the other hand, one of the epithelial markers, epithelial membrane antigen, was strongly positive in all three small-cell carcinomas without argyrophilia and all seven poorly differentiated carcinomas, while it was expressed only weakly and focally in all small-cell carcinomas with argyrophilia except in one case. In conclusion, it is suggested that the immunohistochemical demonstration of several neuroendocrine markers may be helpful in diagnosing neuroendocrine carcinoma of the cervix as a supplement to conventional light microscopy, silver staining, and electron microscopy.

Detection of chromogranin in argyrophil cells of endometrial carcinoma

Normal and neoplastic endometrial tissues were examined immunohistochemically for chromogranin which was shown to be a specific marker for neuroendocrine cells. All 20 normal endometriums and 20 endometrial carcinomas without argyrophilia were chromogranin negative. Endometrial carcinomas with argyrophilia tested were composed of three groups; 10 with type I argyrophil cells, 20 with type II argyrophil cells, and 10 with both type I and II argyrophil cells. Type I argyrophil cells of 20 endometrial carcinomas were all chromogranin positive. Chromogranin immunoreactivity was also intimately correlated with the Grimelius reactivity in type II argyrophil cells of 19 endometrial carcinomas, 13 with only type II argyrophil cells and 6 with mixed type of argyrophil cells. Chromogranin was absent in type II argyrophil cells of 11 endometrial carcinomas, 7 with type II argyrophil cells and 4 with mixed type of argyrophil cells. Chromogranin negativity was related to the disappearance of argyrophilia after diastase digestion in 5 of these 11 tumors, and also partly to mucinous substances in the remaining 6 tumors. In conclusion, the results obtained suggest that some of type II argyrophil cells are neuroendocrine in nature as well as type I argyrophil cells.

An immunohistochemical study of neuroendocrine cells in gynecologic tumors

Various gynecologic tumors with argyrophilia were studied immunohistochemically for chromogranin using two antibodies, antichromogranin and antineuroendocrine. Of seven small cell carcinomas of the cervix, four were immunoreactive with antichromogranin and seven with antineuorendocrine. Argyrophil cells of six cervical adenocarcinomas were all immunoractive with both antibodies. Type I argyrophil cells of 20 endometrial carcinomas were likewise stained positively. However, of the 30 endometrial carcinomas with type II argyrophil cells, 19 showed positive immunoreactivity for chromogranin and 22 for neuroendocrine. Of the ovarian tumors tested, argyrophil cells of 11 mucinous tumors, three carcinoid tumors, and the pancreatic tissue of a malignant mixed germ cell tumor were all chromogranin‐ and neuroendocrine‐immunoreactive. Type I argyrophil cells of five endometrioid carcinomas of the ovary were also immunoreactive with both antibodies. Of the 13 endometrioid carcinomas with type II argyrophil cells, only four showed positive immunoreactivity for chromogranin and only five for neuroendocrine. In conclusion, both antichromogranin and antineuroendocrine detect the specific neuroendocrine markers in close association with argyrophilia in gynecologic tumors, the latter being more sensitive for small cell carcinoma of the cervix, and for type II argyrophil cells in adenocarcinoma of the endometrium and endometrioid carcinoma of the ovary.

An immunohistochemical study of colon-ovarian tumor antigen and colon-specific antigen in gynecologic tumors.

The distribution of colon--ovarian tumor antigen (COTA) and colon-specific antigen (CSA) was studied immunohistochemically in gynecologic tumors. The antigens were absent in the serous benign tumors of the ovary and in the normal ovarian tissues, whereas they were detected in some of the mucinous benign tumors. COTA and CSA were present and similarly distributed in most malignant epithelial tumors of the ovary, with their expression increasing with malignancy. Both antigens were almost completely absent in normal glands of the endometrium, but were expressed in many of the endometrial adenocarcinomas. Adenocarcinomas of the cervix were strongly positive for both antigens, and they were also detected in some of the normal cervical glands. However, no relationship was found between the expression of the two antigens and that of argyrophilia, an intestinal metaplasia.

Realistic fear of cervical cancer risk in Japan depending on birth year

ABSTRACT Objective: In Japan, the possible adverse events upon HPV vaccination was widely reported in the media. MHLW announced the suspension of aggressively encouraging HPV vaccination in 2013, and inoculation rate has sharply declined. The aim of the present study was estimation of future cervical cancer risk. Methods: The latest data on vaccination rate at each age in Sakai City were first investigated. The rate of experiencing sexual intercourse at the age of 12, 13, 14, 15, 16, 17 and throughout lifetime is assumed to be 0%, 1%, 2%, 5%, 15%, 25%, and 85% respectively. The cervical cancer risk was regarded to be proportional to the relative risk of HPV infection over the lifetime. The risk in those born in 1993 whom HPV vaccination was not available yet for was defined to be 1.0000. Results: The cumulative vaccination rates were 65.8% in those born in 1994, 72.7% in 1995, 72.8% in 1996, 75.7% in 1997, 75.0% in 1998, 66.8% in 1999, 4.1% in 2000, 1.5% in 2001, 0.1% in 2002, and 0.1% in 2003. The relative cervical cancer risk in those born in 1994–1999 was reduced to 0.56–0.70, however, the rate in those born in 2000–2003 was 0.98–1.0, almost the same risk as before introduction of the vaccine. Discussion: The cumulative initial vaccination rates were different by the year of birth. It is confirmed that the risk of future cervical cancer differs in accordance with the year of birth. For these females, cervical cancer screening should be recommended more strongly.

A rare malignant ovarian mixed germ cell tumor containing pancreatic tissue with islet cells.

A rare ovarian mixed germ cell tumor containing pancreatic tissue with islet cells was reported. The tumor, weighing 4,500 g, arose in the left ovary of a 29-year-old nulliparous unmarried woman. On section, the tumor was largely solid, but with small- to medium-sized multiple cysts which contained mucinous fluid. Microscopically, the tumor was composed predominantly of immature pancreatic tissue with islet cells budding from the glandular structures, where a few aldehyde-fuchsin-positive cells and some argyrophil cells were seen. Also, insulin-, glucagon-, or somatostatin-reactive cells were localized in these structures by immunohistochemistry. Multiple cysts were covered by a monolayer of benign-looking mucinous epithelium. The tumor contained elements of dysgerminoma, endodermal sinus tumor, immature teratoma, and mucinous adenocarcinoma as minor components. Two years after the surgery followed by chemotherapy with vincristine, actinomycin D, and cyclophosphamide, the patient became pregnant and delivered a healthy female infant.

Detection of human papillomavirus types 16 and 18 in the exfoliated cervical cells using the polymerase chain reaction

We applied the polymerase chain reaction (PCR) to detect HPV 16 and 18 in cytological samples obtained from the uterine cervices of Japanese women. HPV infection was detected in 17 (25%) of 67 with CIN and 11 (37%) of 30 with cervical carcinoma. It is notable that 11 (16%) of 69 women with normal cervices were infected with either HPV 16 or 18. The polymerase chain reaction is sensitive and useful for epidemiological studies.

Project conducted in Hirakata to improve cervical cancer screening rates in 20‐year‐old Japanese: Influencing parents to recommend that their daughters undergo cervical cancer screening

In Japan, the rate of routine cervical cancer screening is quite low, and the incidence of cervical cancer has recently been increasing. Our objective was to investigate ways to effectively influence parental willingness to recommend that their 20‐year‐old daughters undergo cervical cancer screening.