Evaluation of epithelial-specific antigen (ESA) expression in endocervical glandular lesions—Immunocytochemical ESA application to cytological diagnosis

Objective : Cytologically diagnosing early-stage endocervical adenocarcinoma by Pap smear is difficult because lesions are localized high in the canal. We evaluated epithelial-specific antigen (ESA) use in differentially diagnosing endocervical glandular lesions by immunostaining. Study Design : Cytological and histological specimens were taken from 61 cases of endocervical carcinoma—20 in endocervical adenocarcinoma (EA), 10 in adenocarcinoma in situ (AIS), 11 in carcinoma in situ (CIS), and 20 in invasive squamous cell carcinoma (SCC). Immunostaining used monoclonal ESA antibody and simple MAX (PO) staining. Results were analyzed in semiquantitative evaluation. Results : Histological ESA was expression in the basolateral membrane of normal endocervical gland cells and cytological ESA negative or weakly positive in normal endocervical cell cytoplasm. ESA expression was found histologically and cytologically to be strengthened more in AIS and EA than in SCC and CIS. Conclusion : ESA is cytologically useful in detecting neoplastic endocervical gland cells.