Various metaplastic changes may be present in endometrium, in which also cellular atypias may often be observed. Particularly, eosinophilic and ciliated changes (ECCs) occur in both nonneoplastic and neoplastic endometrium. This may cause
confusion in the cytodiagnosis. This study was enterprised to investigate the possible help of immunocytochemical and cytogenetic study in the diagnostic and
biologic assessment of ECC cells. In immunocytochemistry for p53
protein, Ki-67, and
cyclin A, the material consists of 40 cases of cytologic smears examined by direct sampling of the endometrial cavity comprising 30 cases of ECC in endometrial glandular and stromal breakdown (EGBD) and 10 cases of well-differentiated
adenocarcinoma (G1). After cytodiagnosis, immunostaining for p53
protein, Ki-67, and
cyclin A was performed on multiple wet-fixed slides from each single case to evaluate the immunoreactivity, intensity of nuclear staining, and nuclear labeling index (N-LI). The intensity of nuclear staining was scored as negative (0), weak (1), moderate (2), or strong (3), and the N-LI was scored as less than 10% (0), from 10% to 25% (1), from 26% to 50% (2), or more than 50% (3), and the final score was calculated by adding both partial scores. A statistical significance test was performed by using Mann-Whitney U test, and the result was judged as significant when the P value was less than .05. For genetic mutation analysis of p53, the material comprised 6 cases of EGBD in which a high score was measured with immunocytochemistry for p53
protein, and the presence of ECC was confirmed on the
hematoxylin and
eosin. The ECC cells on
paraffin-embedded specimens were captured using
laser capture microdissection technology. Mutations in p53 gene (exons 5-8) were examined using
DNA sequencing analysis. In immunocytochemistry for p53
protein, Ki-67, and
cyclin A, the proportions of immunoreactive cells for p53 were statistically higher in ECC compared with those of G1 (P < .05). The proportions of the immunoreactive cells for Ki-67 and
cyclin A were statistically higher in G1 compared with those of ECC (P < .05). (2) In genetic mutation analysis of p53,
DNA sequencing of p53 in 6 cases revealed no mutations. The percentage of immunoreactive cells for p53
protein were higher in ECC than in G1, but the mutation point was not confirmed in genetic mutation analysis. The differential expression of these
biologic parameters in ECC cells could be considered of possible relevance to the cytopathologic diagnosis in the future.