Independent prognostic value of peritoneal immunocytodiagnosis in endometrial carcinoma

Among the clinical parameters that play a pivotal role in predicting the ou tcome of patients with endometrial carcinoma, intrapeitoneal microscopic di ssemination represents an important cause of recurrences. To date, peritone al cytology has been incorporated into the current surgical staging system (International Federation of Gynecology and Obstetrics 88), although its pr edictive value remains a controversial issue. In this at;dy the: authors in vestigated the possibility of applying immunocytochemistry (ICC) to the dia gnosis of peritoneal washing (PW) aimed at improving conventional cytology and verifying the prognostic value of peritoneal malignant cells. The autho rs analyzed 182 PWs sampled from endometrial cancer patients. The ICC analy sis was performed using two monoclonal antibodies (MAbs)-AR-3 and B72.3-tha t in combination recognize more than 95% of endometrial carcinomas. The pre sence of peritoneal-free cancer cells was identified morphologically in 27 of 182 lavages (14.8%) and ICC in 50 of 182 (27.5%), with a significant imp rovement (p <0.0001). Five-year survival analysis, comparing results of ICC and cytodiagnosis, demonstrated a significant decrease of disease-free sur vival in patients with peritoneal microscopic disease. Furthermore, multiva riate analysis showed that ICC diagnosis of PWs is an independent prognosti c factor. Data indicate that the use of selected MAbs allows one to identif y cytologically false-negative cases, providing results that are highly pre dictive of a worse clinical outcome.