Objective: It was the aim of this study to evaluate the diagnostic utility of Notch-1 immunocytochemistry in distinguishing endometrial glandular and stromal breakdown (EGBD) from endometrial adenocarcinoma in endometrial cytology. Study Design: Samples of normal endometrium, EGBD and endometrial adenocarcinoma were subjected to immunocytochemical staining for Notch-1, and we examined the labeling index (LI) of Notch-1 (the ratio of intranuclear Notch-1-positive cells to total cells). We compared (1) the Notch-1 LI in normal endometrium, (2) the Notch-1 LI between normal endometrium and endometrial adenocarcinoma, and (3) the Notch-1 LI in normal endometrium, EGBD and endometrial adenocarcinoma. Results: In analysis item 1, the LI of Notch-1 was 32.9 ± 8.4, 19.4 ± 8.2 and 12.5 ± 7.5% in proliferative endometrium, secretory endometrium and atrophic endometrium, respectively. In analysis item 2, the LI of Notch-1 in endometrial adenocarcinoma was 45.2 ± 7.4%, which was significantly higher than that in normal endometrium. In analysis item 3, the LI of Notch-1 in EGBD was 31.3 ± 8.3%, which was significantly lower than that in endometrial adenocarcinoma. Conclusion: In conclusion, Notch-1 immunocytochemistry is a useful method for distinguishing between EGBD and endometrial carcinoma in endometrial cytology.

1.
Ushijima K: Current status of gynecologic cancer in Japan. J Gynecol Oncol 2009;20:67–71.
2.
Watanabe J, Nishimura Y, Tsunoda S, Kawaguchi M, Okayasu I, Kuramoto H: Liquid-based preparation for endometrial cytology – usefulness for predicting the prognosis of endometrial carcinoma preoperatively. Cancer 2009;117:254–263.
3.
Kipp BR, Medeiros F, Campion MB, Distad TJ, Peterson LM, Keeney GL, Halling KC, Clayton AC: Direct uterine sampling with the Tao brush sampler using a liquid-based preparation method for the detection of endometrial cancer and atypical hyperplasia: a feasibility study. Cancer 2008;114:228–235.
4.
Ferenczy A: Pathophysiology of endometrial bleeding. Maturitas 2003;45:1–14.
5.
Norimatsu Y, Shimizu K, Kobayashi TK, Moriya T, Kaku T, Tsukayama C, Miyake Y, Ohno E: Endometrial glandular and stromal breakdown, part 2: cytomorphology of papillary metaplastic changes. Diagn Cytopathol 2006;34:665–669.
6.
Shimizu K, Norimatsu Y, Kobayashi TK, Ogura S, Miyake Y, Ohno E, Sakurai T, Moriya T, Sakurai M: Endometrial glandular and stromal breakdown, part 1: cytomorphological appearance. Diagn Cytopathol 2006;34:609–613.
7.
Shimizu K, Norimatsu Y, Kobayashi TK, Sakurai M, Ogura S, Yoshizawa A, Miyamoto T, Miyake Y, Aratake Y, Sakaguchi T, Ohno E: Expression of immunoreactivity and genetic mutation in eosinophilic and ciliated metaplastic changes of endometrial glandular and stromal breakdown: cytodiagnostic implications. Ann Diagn Pathol 2009;13:89–95.
8.
Norimatsu Y, Yuminamochi T, Shigematsu Y, Yanoh K, Ikemoto R, Masuno H, Murakami M, Kobayashi TK: Endometrial glandular and stromal breakdown, part 3: cytomorphology of ‘condensed cluster of stromal cells’. Diagn Cytopathol 2009;37:891–896.
9.
Bigas A, Robert-Moreno A, Espinosa L: The Notch pathway in the developing hematopoietic system. Int J Dev Biol 2010;54:1175–1188.
10.
Wilson A, Radtke F: Multiple functions of Notch signaling in self-renewing organs and cancer. FEBS Lett 2006;580:2860–2868.
11.
Bolós V, Grego-Bessa J, de la Pompa JL: Notch signaling in development and cancer. Endocr Rev 2007;28:339–363.
12.
Ellisen LW, Bird J, West DC, Soreng AL, Reynolds TC, Smith SD, Sklar J: TAN-1, the human homolog of the Drosophila notch gene, is broken by chromosomal translocations in T lymphoblastic neoplasms. Cell 1991;66:649–661.
13.
Reedijk M, Odorcic S, Chang L, Zhang H, Miller N, McCready DR, Lockwood G, Egan SE: High-level coexpression of JAG1 and NOTCH1 is observed in human breast cancer and is associated with poor overall survival. Cancer Res 2005;65:8530–8537.
14.
Wang Z, Zhang Y, Li Y, Banerjee S, Liao J, Sarkar FH: Down-regulation of Notch-1 contributes to cell growth inhibition and apoptosis in pancreatic cancer cells. Mol Cancer2006;5:483–493.
15.
Kim KH, Kim JM, Choi YL, Shin YK, Lee HC, Seong IO, Kim BK, Chae SW, Chung YS, Kim SH: Expression of sonic hedgehog signaling molecules in normal, hyperplastic and carcinomatous endometrium. Pathol Int 2009;59:279–287.
16.
Soares R, Balogh G, Guo S, Gärtner F, Russo J, Schmitt F: Evidence for the notch signaling pathway on the role of estrogen in angiogenesis. Mol Endocrinol 2004;18:2333–2343.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.