Fine-needle aspiration cytology of breast lesions: a review of cytological analysis using smooth muscle actin (SMA) immunostaining.

We reviewed fine-needle aspiration (FNA) cytology cases for breast lesions in order to improve the reliability of cytological diagnoses. We analyzed the results of 1,019 FNA cytology cases of patients with breast lesions for five years in our hospital. One hundred and ninety-seven (19.3%) of the 1,019 cases were examined using histological sections, in addition to cytological specimens, and included 27 cytologically suspicious cases. Of the 1,019 cytology cases, 606 (59.5%) were benign, 41 (4.0%) suspicious, 149 (14.6%) malignant and 223 (21.9%) inadequate/nondiagnostic. We also performed immunostaining against smooth muscle actin (SMA), using 19 cytological specimens and 88 histological specimens. We observed myoepithelial cells positive for SMA, which were valuable for cytological or histological diagnosis. To improve the reliability of cytological diagnoses and decrease the false-positive and false-negative cases, it is very important to obtain sufficient aspirates and to understand the cytological characteristics of various benign and malignant breast lesions.

Expression of CD44 in primary lung carcinomas using histological and cytological analyses.

CD44 is a family of transmembrane glycoproteins expressed in hematopoietic and epithelial cells, and associated with diverse physiological functions such as cell-cell and cell-matrix interactions. CD44 exists in a standard form, CD44s, and in multiple isoforms which are produced by alternative splicing of the variant exons (exon v1 to exon v10) encoding parts of the extracellular domain. Recently, CD44 was shown to play a role in the invasive and metastatic properties of tumor cells. In this study, we demonstrated CD44 immunoreactivities in 74 primary lung carcinomas. CD44s was noted in 38% (28 out of 74) of primary lung carcinomas. CD44v3 (38%, 28 out of 74) and CD44v6 (41%, 30 out of 74) were less frequently expressed in the primary lung carcinomas, compared with non-neoplastic lung tissues (CD44v3, 100%, p < 0.001; CD44v6, 73%, p < 0.05), respectively. CD44v3 and CD44v6 were more frequently found in squamous cell carcinomas than the other histological types (p < 0.05. CD44s, CD44v3 and CD44v6 were noted in 33% (6 out of 18), 44% (8 out of 18) and 33% (6 out of 18) of cytology-positive cases, and in 46% (6 out of 13), 38% (5 out of 13) and 31% (4 out of 13) of cytology-negative cases, respectively. It is suggested that decreased CD44v3 and CD44v6 might be correlated with sputum cytology-negative cases of lung adenocarcinoma.

Decreased nm23 expression, but not Ki-67 labeling index, is significantly correlated with lymph node metastasis of breast invasive ductal carcinoma.

The nm23 gene was originally identified by differential hybridization of metastatic murine melanoma cell lines. Some experimental studies demonstrated a significantly reduced metastatic potential of melanoma cell lines transfected with the nm23 gene. In this study, we clarified the relationship between lymph node status and nm23 immunoreactivity, as well as Ki-67 labeling index (LI), of human breast cancer. Of the 44 breast invasive ductal carcinomas, nm23-diffusely positive expression [nm23(+)] was detected in 17 (38.6%), and focally positive/negative expression [nm23(+/-/-)] in 27 (61.4%) cases. Lymph node metastasis was found at a significantly higher incidence in the nm23(+/-/-) cases (18/27, 66.7%) than in the nm23(+) cases (4/17, 23.5%) (p>0.001). In the lymph node metastasis-positive cases, mean LI of Ki-67 cells was 20.9% at the center of the tumors and 24.0% at the advanced margins. In the lymph node metastasis-negative cases, mean LI of Ki-67 cells was 12.4% at the center of the tumors and 27.2% at the advanced margins. Decrease of nm23 expression, but not Ki-67 LI, was significantly correlated with lymph node metastasis of breast invasive ductal carcinoma.