Use of intermediate filament antibodies in the differential diagnosis of gynecological neoplasia

Our plain-English summary of Use of intermediate filament antibodies in the differential diagnosis of gynecological neoplasia, by F.C. Ramaekers, J.J. Puts, P. Kenemans, et al (European Journal of Obstetrics, Gynecology, and Reproductive Biology, 1985).

The study

• Authors: F.C. Ramaekers, J.J. Puts, P. Kenemans, G.P. Vooijs
• Journal: European Journal of Obstetrics, Gynecology, and Reproductive Biology
• Published: 1985;19(6):347-53
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

The authors, from the University of Nijmegen in the Netherlands, described how antibodies to intermediate filament proteins could help in the differential diagnosis of gynecological tumors. They explained that epithelial cells contain cytokeratins, mesenchymal cells vimentin, and muscle cells desmin. They used polyclonal antibodies to cytokeratin, vimentin and desmin, and two monoclonal antibodies they had prepared: RGE 53, which reacted with glandular and columnar epithelium and adenocarcinomas, and RKSE 60, which reacted with keratinizing squamous epithelium. They first checked the antibodies' specificity on gynecological tumors that are usually not difficult to diagnose, including ovarian cystadenocarcinomas, adenocarcinomas of the uterine corpus and cervix, squamous cell carcinomas of the cervix and vulva, and uterine leiomyomas. They then applied them to three heterogeneous tumors that had been hard to classify with routine histology. In a 58-year-old woman with ovarian tumors first read as poorly differentiated adenocarcinoma, desmin staining found rhabdomyoblasts, which established a mesodermal mixed tumor. In a mural nodule within an ovarian mucinous cystadenocarcinoma, intermingled cytokeratin-positive and vimentin-positive components indicated a carcinosarcomatous lesion. A uterine tumor first diagnosed as carcinosarcoma was cytokeratin-positive in both components, which led to a diagnosis of adenosquamous carcinoma. The authors concluded that intermediate filament antibodies can be valuable tools in surgical pathology, helping to classify heterogeneous gynecological tumors and so to guide staging and treatment.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article is not about asbestos. The authors, from the University of Nijmegen in the Netherlands, described how they used antibodies against intermediate filament proteins to help classify tumors of the female reproductive organs. These proteins are cytokeratins (in epithelial cells), vimentin (in mesenchymal cells) and desmin (in muscle cells). The authors first checked the antibodies on gynecological tumors that are usually easy to diagnose. For example, serous cystadenocarcinoma cells of the ovary stained for cytokeratin but not vimentin, while the surrounding stroma stained strongly for vimentin. They then described three difficult cases. In a 58-year-old woman, desmin staining showed scattered rhabdomyoblasts in ovarian tumors first read as adenocarcinoma, which established a diagnosis of mesodermal mixed tumor. A nodule in an ovarian cystadenocarcinoma was judged to be a carcinosarcomatous lesion. A uterine tumor first diagnosed as carcinosarcoma was reclassified as adenosquamous carcinoma. Mesothelioma appears only in a table listing which tumors each antibody reacts with. No mesothelioma cases were reported. The authors concluded that these antibodies can be valuable tools in surgical pathology.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Description of an antibody staining method with three illustrative case descriptions (no statistical study)
• Who was studied: Gynecological tumors examined at the University of Nijmegen, the Netherlands. First, tumors that are normally easy to diagnose; then three diagnostically difficult cases: a 58-year-old woman with ovarian tumors, a nodule in an ovarian cystadenocarcinoma, and a tumor of the uterus. No total count of specimens is given.
• Exposure: No asbestos or other environmental exposure was studied. The study concerned staining of tumor tissue with polyclonal and monoclonal antibodies to intermediate filament proteins (cytokeratins, including the monoclonal antibodies RGE 53 and RKSE 60, vimentin and desmin).
• Main results:
  • In papilliferous serous cystadenocarcinomas of the ovary, tumor cells stained with polyclonal cytokeratin antibodies but were negative for vimentin, while stromal elements were strongly vimentin-positive.
  • First case (58-year-old woman): re-evaluation of ovarian tumors first interpreted as poorly differentiated adenocarcinoma revealed scattered rhabdomyoblasts, establishing a diagnosis of mesodermal mixed tumor.
  • Second case: cytokeratin and vimentin staining showed that a nodule in an ovarian cystadenocarcinoma contained intermingled carcinomatous and sarcomatous components. The authors judged it a carcinosarcomatous lesion.
  • Third case: a uterine tumor first diagnosed as carcinosarcoma showed cytokeratin positivity in both the carcinomatous and the supposed chondrosarcomatous areas, plus RKSE 60 positivity. This led to a diagnosis of adenosquamous carcinoma.
  • The article's table of antibody reactivity lists mesotheliomas among the tumors recognized by the polyclonal cytokeratin antibody and by RGE 53. No mesothelioma cases were examined in the text.
• The authors' conclusion: The authors concluded that antibodies to intermediate filaments can be valuable tools in surgical pathology, helping to classify the components of heterogeneous gynecological tumors and so facilitate proper staging and treatment.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Ovarian cancer.

Medical terms in this study, explained in our Lexicon: Differential Diagnosis, Desmin, Monoclonal, Epithelium, Adenocarcinoma, Squamous Cell Carcinoma, Histology, Carcinoma.

Related studies

• Keratins 7 and 20 as diagnostic markers of carcinomas metastatic to the ovary — C.C. Wauters, F. Smedts, et al. (1995)
• Intermediate filament expression in mesotheliomas: leiomyoid mesotheliomas are not uncommon — F.G. Mayall, H. Goddard, et al. (1992)
• Immunohistochemical distinction of malignant mesothelioma from pulmonary adenocarcinoma with anti-surfactant apoprotein, anti-Lewisa, and anti-Tn antibodies — M. Noguchi, T. Nakajima, et al. (1989)
• Cytopathology of serous neoplasia of the ovary and the peritoneum: differential diagnosis from mesothelial proliferations — L.R. Pisharodi, C.W. Bedrossian (1996)
• An ultrastructural comparison of mesotheliomas and adenocarcinomas of the ovary and endometrium — M.J. Warhol, N.J. Hunter, et al. (1982)
• Peritoneal washing cytology findings of disseminated myxoid leiomyosarcoma of uterus: report of a case with emphasis on possible differential diagnosis — W.K. Ng, P.C. Lui, et al. (2002)

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