An assessment of the value of epithelial membrane antigen and other epithelial markers in solving diagnostic problems in tumour histopathology

Sloane, J P; Hughes, Felix A.; Ormerod, M.G.

doi:10.1007/bf01002986

Cited by 64 publications

(16 citation statements)

References 11 publications

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“…Anti-EMA serum is known to stain occasional lymphoid cells (Delsol et al, 1984). For unknown reasons such staining is mainly observed in lymphomas, but in our and in other workers' experience (Sloane et al, 1983) this does not usually happen in reactive lymph nodes. Plasma cells did occasionally show a faint staining of the cell membrane with anti-EMA serum; their nature however could be easily interpreted.…”

Section: Discussionmentioning

confidence: 83%

The immunohistochemical detection of lymph node metastases from infiltrating lobular carcinoma of the breast

Bussolati¹,

Gugliotta²,

Morra³

et al. 1987

Br J Cancer

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Summary Immunological markers improve specificity and accuracy of cell detection, therefore it is important to evaluate their usefulness in improving standard histological procedures.This study investigates whether immunocytochemical techniques increase the accuracy of detection, in axillary lymph nodes, of metastatic cells from infiltrating breast lobular carcinoma (ILC).Fifty cases of ILC reported to be node-negative were selected. New serial sections were cut from a total of 767 lymph nodes, stained with H&E and tested in immunoperoxidase (ABC procedure) with a conventional anti-Epithelial Membrane Antigen (EMA) serum, with a monoclonal raised against human milk fat globule membranes (HMFG-2) and with a monoclonal against 54kd keratin. Metastases were detected immunocytochemically in 12 cases (24%); in five of these cases metastatic cells were also visible in serial H&E sections. Monoclonals offered no evident advantage over anti-EMA conventional antiserum. Immunocytochemical positivity alone is not sufficient evidence for metastatic invasion since macrophages occasionally appear EMA-and HMFG-2-positive (probably because of secondary incorporation of the antigen), and so an improvement in the accuracy of breast cancer metastatic cell detection in axillary lymph nodes requires a combined histo-immunological approach.Prognosis and treatment of breast cancer is heavily influenced by the detection of metastases in lymph nodes. Foci formed by clumps of cells are easily spotted in standard histological sections, but a more difficult task is the detection of metastatic foci of one or few cells spread within a tissue.In as many as 24% of lymph nodes reported free of metastases by standard histological examination, various authors found metastases when multiple or serial sections were cut (Pickren, 1961;Fisher et al., 1978b). Immunological markers also improve the specificity and accuracy of cell detection, therefore it is important to evaluate their usefulness in improving standard histological procedures.Wells et al. (1984) utilizing 3 monoclonal antibodies found micro-metastatic foci in about 20% of lymph nodes from 45 cases of ductal or lobular breast cancer reported negative on conventional histology. On the contrary Sloane et al. (1980) reached the conclusion that detection of metastases in lymph nodes was not improved by immunocytochemistry. However they used a polyclonal antiserum against fat globule membranes of human milk.In this study 50 cases of infiltrating lobular carcinoma of the breast reported to have axillary lymph nodes free of metastases were re-examined to determine whether occult metastases were revealed

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Section: Discussionmentioning

confidence: 83%

The immunohistochemical detection of lymph node metastases from infiltrating lobular carcinoma of the breast

Bussolati¹,

Gugliotta²,

Morra³

et al. 1987

Br J Cancer

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“…Immunohistochemical studies have since shown that EMA is localized in a variety of normal epithelia and neoplastic tissues [8,26,27], Transitional epithelial cells, for example, were positively stained by the antibody against EMA [26]. Furthermore, Pocock et al [24] showed the localization of EMA in the cells of transitional cell carcinoma of the urinary bladder.…”

Section: Introductionmentioning

confidence: 99%

Epithelial Membrane Antigen as an Immunohistochemical Marker for Transitional Cell Carcinoma of the Urinary Bladder

Takashi¹,

Murase²,

Kinjo³

et al. 1987

Urol Int

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Epithelial membrane antigen (EMA) was immunohistochemically localized in transitional cell carcinomas of the bladder to clarify EMA staining pattern’s relationship to the histological grading and staging of tumors and patient prognosis. Formalin-fixed, paraffin-embedded sections from 101 patients with bladder carcinoma were stained by the indirect immunoperoxidase method. In the lower histological grade and stage of transitional cell carcinoma, the localization of EMA was restricted to the luminal surface of the superficial cells. Membrane and cytoplasmic staining of EMA was frequently found in the intermediate and basal layers of the tumor cells, and the incidence of cytoplasmic staining increased with advancing grade and stage. Stromal staining was frequently observed in cases of higher grade and stage. In addition, these distribution patterns of EMA were well correlated with patient survival. Thus, we differentiated three types of EMA distribution: a luminal type, with very good prognosis; a cytoplasmic type, with fair prognosis; and a stromal type, with relatively poor prognosis. These findings suggest that EMA distribution in bladder cancer could be a valuable indicator for histological grading or staging in pathological diagnosis and for predicting the survival of bladder cancer patients.

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“…Carbohydrates form the major components and antigenic determinants of EM A , the principal sugars being galactose, N-acetyl glucosamine and N-acetylgalactosamine in descending order of impor tance. EM A was first immunohistochemically localized in transitional epithelial cells by Sloane et al [10,11], its presence in transitional cell carcinomas being confirmed by Pocock et al [12]. Subsequently Takashi et al [13] observed a good correlation between EM A immunohistochemical staining pattern and patient prognosis in cases of transitional cell carcinoma of the urinary bladder.…”

Section: Discussionmentioning

confidence: 74%

“…Sloane and Ormerod [10], Sloane et al [11] and Pocock et al [12] immunohistochemically localized epi thelial membrane antigen (EMA), a glycoprotein recog nized by antisera raised against human milk fat globule membrane in transitional cell carcinomas of the urinary bladder. Takashi et al [13] observed a good correlation between EM A immunohistochemical staining pattern and prognosis of patients with bladder carcinoma.…”

Section: Introductionmentioning

confidence: 99%

Immunocytochemically Demonstrated Expression of Epithelial Membrane Antigen and Carcinoembryonic Antigen by Exfoliated Urinary Cells in Patients with Bladder Cancer

Tanaka

Takashi²,

Miyake³

et al. 1994

Urol Int

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The localization of epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA) in exfoliated cells from voided urine was examined to clarify whether immunostaining for these markers is more useful than conventional cytology for diagnosis of patients with transitional cell carcinoma of the bladder. Both EMA and CEA were present more frequently in specimens from higher-grade and higher-stage tumors than lower-grade and lower-stage tumors. Cells positive for one or both of these markers were also found in specimens from cancer patients with only suspicious results by conventional cytology. In grade 1 tumors, the positive rates were 50% for EMA staining and 40% for CEA staining compared with 10% for conventional cytology. In 12 patients with cystitis, results for EMA staining and conventional cytology were all negative, whereas CEA staining proved positive in 6 patients (50%). None of 10 normal subjects with conventional cytology had positive results for EMA or CEA staining. These findings indicate that immunocytochemistry for EMA is a more useful adjunctive method than CEA staining or conventional cytology for detection of tumor cells, especially in cases of low-grade bladder cancer.

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An assessment of the value of epithelial membrane antigen and other epithelial markers in solving diagnostic problems in tumour histopathology

Cited by 64 publications

References 11 publications

The immunohistochemical detection of lymph node metastases from infiltrating lobular carcinoma of the breast

The immunohistochemical detection of lymph node metastases from infiltrating lobular carcinoma of the breast

Epithelial Membrane Antigen as an Immunohistochemical Marker for Transitional Cell Carcinoma of the Urinary Bladder

Immunocytochemically Demonstrated Expression of Epithelial Membrane Antigen and Carcinoembryonic Antigen by Exfoliated Urinary Cells in Patients with Bladder Cancer

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