Yasuki Sakamoto

Tn antigen, a marker of potential for metastasis of uterine cervix cancer cells.

Background. The expressions of Thomsen–Friedenreich antigen (T‐Ag) and Tn antigen (Tn‐Ag), precursors of MN blood group antigens, were examined in the tissues of squamous cell carcinoma of the uterine cervix from 111 patients to determine their clinicopathologic significance with regard to the biologic behaviors of cancer cells and the clinical course of the patients.

Differences in clinical significance of blood group antigens A, B, and H in carcinoma tissue in the uterine cervix

The losses of blood group antigens A, B, and H in carcinoma tissue of the uterine cervix were studied by the avidin-biotin-peroxidase complex (ABC) method and the relations of these losses to invasion and dedifferentiation of primary cancer were examined. The incidence of cases showing complete loss of A or B antigen increased in proportion to the progression of cancer, but in most cases even of invasive cancer, H antigen, the precursor of A and B antigens, was detected. Complete loss of H antigen was not demonstrated in well-differentiated keratinizing invasive carcinomas, but was seen in 15% (15/101) of the cases of large cell non-keratinizing type cancer and 50% (8/16) of those of small cell non-keratinizing type cancer. No relationship was found between losses of A, B, and H antigens and parametrial spread of carcinoma or metastasis to the pelvic lymph nodes, but the incidence of death within 2 years after hysterectomy was higher in H antigen-negative cases than in H antigen-positive cases. These results indicate that loss of A and B antigens depends on some activity of invasion of cancer, while loss of H antigen strongly indicates dedifferentiation of cancer cells and also may indicate a poor prognosis.

Thickness of uninvolved fibromuscular stroma and extrauterine spread of carcinoma of the uterine cervix

The minimum thickness of cervical fibromuscular stroma remaining uninvolved with invasive cervical carcinoma was examined in relation to pelvic node metastases and 5‐year cancer death rate, using specimens from Stage IB, IIA, and IIB patients who underwent radical hysterectomy and pelvic lymphadenectomy. The nodal metastasis and 5‐year cancer death rates were 7% and 8%, respectively, in patients with the uninvolved fibromuscular stroma thickness above 3 mm, and 37% and 26%, respectively, in patients with the thickness below 3 mm. The thickness of cancer‐unaffected cervical fibromuscular stroma seemed to be closely related to and to be a more useful parameter of the biological behavior of invasive cervical carcinoma than the depth of the cancer invasion. A threshold value of the minimum thickness of the tissue as a barrier against extrauterine spread of cervical cancer could not be identified in this study.

Colposcopy for postmenopausal women

The number of postmenopausal women colposcopically diagnosed has markedly increased during the last 15 years. In some of them, a clear colposcopic impression, required for planning an appropriate therapy, was disturbed by severe senile cervicocolpitis, when examined by the conventional technique using acetic acid. With a 5-year experience of 79 paired colposcopies, it was concluded that estrogen administration is necessary as a routine precolposcopic procedure in such cases and oral administration of conjugated estrogens at 1.25 mg/day for 14 days is adequate for this purpose.

Colposcopic findings of gland openings in cervical carcinoma: Their histological backgrounds

During the past 8 years 1501 colposcopies were performed paying a special attention to cervical glands for diagnosis of cervical intra‐epithelial neoplasia (CIN) and carcinoma. Normal openings could exclude these diseases at the error rate of only 5.1%, while atypical openings could identify them at the high confidence rate of 96.3%. False positive evaluations were mostly attributable to a marked degree of squamous metaplasia in the glands. The absence of gland openings in the main portion of the lesions amounted to 88.6% in invasive carcinomas but to only 12.4% in CIN. Adenoma malignum was a highly characteristic exception.