Tetsuji Kurokawa

The expression pattern of CD10 and CD31 identifies fine fibrovascular stroma of grade 1‐endometrial endometrioid carcinomas in cytology

AbstractIntroductionThe objective of this study was to assess the diagnostic utility of CD10 in the differential diagnosis of grade 1‐endometrial endometrioid carcinoma (G1‐EEC) and the metaplastic changes associated with the endometrial glandular and stromal breakdown (EGBD) on liquid‐based cytological (LBC) samples.Methods(1) The type and distribution of CD10‐positive cells in EGBD and G1‐EEC patients were evaluated. (2) Based on the results from (1), histological and cytological specimens were double‐immunostained with CD31 and CD10 to confirm whether CD10‐positive tubular‐canalicular material found in (1) was represented by fine threads of endometrial‐type fibrovascular stroma. (3) Based on the results from (2), additional immunostaining of histological specimens was performed for CD146 and αSMA as markers of perivascular cells.Results(1) CD10 positive cells showed two main patterns of expression: cytoplasmic immunoreactivity in the form of dense brown granules in EGBD and tubular‐canalicular branching patterns in G1‐EEC. (2) The tubular‐canalicular material observed in cytological specimens of G1‐EEC samples co‐expressed CD10 and CD31, and was interpreted as representing fine threads of endometrial fibrovascular stroma in the corresponding histological samples. Conversely, metaplastic changes in EGBD cases, only a few CD31‐positive signals were found inside the condensed stromal clusters with CD10‐positive. (3) Cells surrounding the CD31‐positive vascular endothelial cells expressed CD146 and αSMA; moreover, some of the thin CD10‐positive fibrous stromal strands also co‐expressed αSMA.ConclusionsCD10 is a very useful immunomarker for distinguishing between G1‐EEC and the metaplastic changes of EGBD in LBC samples.

Nuclear morphometry as an adjunct to cytopathologic examination of endometrial brushings on LBC samples: A prospective approach to combined evaluation in endometrial neoplasms and look alikes

AbstractObjectiveIn this study, we aimed to retrospectively investigate and confirm whether atypical nuclear findings in endometrial cytology are useful when assessed by image morphometry in liquid‐based cytology (LBC) and compared with microscopic evaluation.MethodsIn total, 53 cases were selected for this study, including 11 presenting proliferative endometrium, 12 with surface papillary syncytial change with endometrial glandular and stromal breakdown (EGBD‐SPSC), 10 endometrioid carcinoma grade 1 (G1‐EEC), 10 EEC grade 3 (G3‐EEC), and 10 endometrial serous carcinomas (ESC). Nuclear image morphometry for nuclear geometric features (area, grey value, aspect ratio, internuclear distance, nucleolar diameter) was performed using ImageJ computer software. For assessing nucleoli, 3861 nuclei were measured, and for nuclear findings, except for nucleoli, 4036 nuclei were measured in total.Results(a) Compared with G1‐EEC, G3‐EEC and ESC presented a marked increase in all six parameters (nuclear enlargement, anisonucleosis, nuclear shade, nuclear shape, irregularity of nuclear arrangement, and nucleolar size). (b) EGBD‐SPSC presented a marked increase in two parameters (nuclear shade, nuclear shape) when compared with G1/G3‐EEC and ESC. (c) Compared with EGBD‐SPSC, EEC and ESC demonstrated a marked increase in nucleolar size (≥2.0 μm). (d) ESC presented a marked increase in nucleolar size (≥3.0 μm) when compared with G3‐EEC.ConclusionsHere we confirmed that atypical nuclear findings evaluated by image morphometry are as useful as microscopic evaluations in endometrial cytology. We believe that the objective evaluation of nucleolar size could contribute to an accurate diagnosis of endometrial‐LBC samples.

Combination therapy with paclitaxel and trastuzumab for human epidermal growth factor receptor 2‐positive recurrent serous carcinoma of the uterine cervix: A case report

Abstract Recent studies show increased expression of human epidermal growth factor receptor 2 (HER2) in cervical cancer, but the efficacy of anti‐HER2 therapy remains under‐researched. Here, we present a case of recurrent HER2‐positive serous carcinoma, presumably arising in the cervix, diagnosed by comprehensive genomic profiling, which responded to trastuzumab. The patient underwent a radical hysterectomy with concurrent adjuvant chemoradiotherapy. One year after surgery, the patient experienced recurrence (multiple lymph node metastases). She underwent chemotherapy and subsequent comprehensive genomic profiling, which revealed HER2 positivity. Despite treatment, the lymph node and peritoneal metastases progressed. Therefore, combination chemotherapy with paclitaxel and trastuzumab was initiated. Subsequently, the patient's clinical symptoms improved considerably, and good health was maintained for 8 months. This report highlights the importance of comprehensive genomic profiling and targeted therapies when standard treatments fail.

Is the catch‐up program of HPV vaccination for Japanese adult women effective or not?

Evaluation of the feasibility of human papillomavirus sponge‐type self‐sampling device at Japanese colposcopy clinics

AbstractAimSelf‐sampling human papillomavirus (HPV) testing has been introduced for cervical cancer screening worldwide. In Japan, there are two types (brush and sponge) of HPV self‐sampling devices. However, the recommended type for cervical cancer screening remains unclear. This study aimed to evaluate the feasibility of the HPV self‐sampling device–sponge type (HSD‐ST). Additionally, we aimed to examine the positive rate (sensitivity) for cervical intraepithelial neoplasia (CIN) 2 or worse using the HSD‐ST. Finally, we aimed to perform a questionnaire survey regarding the usability of the HSD‐ST.MethodsWe included 165 women who underwent HPV testing at one of three gynecologic clinics. First, the women used the HSD‐ST and completed a questionnaire regarding its usability. Subsequently, they underwent physician‐sampling HPV testing and cytology. We examined the agreement rate of HPV positivity between self‐ and physician‐sampling HPV testing.ResultsThe HPV‐positive rates of self‐ and physician‐collected samples were 59.4% and 62.4%, respectively, with an overall concordance rate of 88.5% and a calculated kappa coefficient of 0.76, indicating high concordance. Moreover, the positive (sensitivity) rates for CIN2 or worse were 81.4% and 89.8% in the self‐ and physician‐collected samples, respectively.ConclusionsOur findings demonstrated the feasibility and usability of the HSD‐ST.