title: Endometrial and endocervical secretion: the search for histochemical differentiation.
abstract: OBJECTIVE
  To determine the ideal histochemical stain to differentiate between non-neoplastic and neoplastic endocervix and endometrium.
  
  
  METHODS
  A total of 90 cases representing nonneoplastic cervix, non-neoplastic endometrium, endocervical adenocarcinoma and endometrial adenocarcinoma were stained with toluidine blue (TB); methylene blue (MB); mucicarmine (MUC); periodic acid-Schiff before and after diastase digestion (PAS, PAS-D); Alcian blue, pH 2.5 (AB); and periodic acid-Schiff after Alcian blue, pH 2.5 (PAB). Cases were blinded and randomly divided between two pathologists for evaluation of the staining and the staining distribution of the glandular epithelium by means of a 36-color scheme.
  
  
  RESULTS
  The majority of non-neoplastic endocervix samples stained blue with MB (57%), fuchsia with MUC (70%), magenta with PAS (77%) and PAS-D (73%) and dark turquoise with AB (70%). The majority of non-neoplastic endometrium samples stained slate blue with TB (60%) and pink with PAS-D (53.3%). There is statistical difference (p < 0.05) in the color of the epithelium and secretions between the non-neoplastic cervix and endometrium. The malignant glands of endocervical origin could be differentiated significantly (p = 0.043) from non-neoplastic endocervical epithelium by MUC. The epithelium of the non-neoplastic endometrium is significantly differentiated from malignant endometrium using TB (p = 0.015) and MB (p = 0.038). Endocervical carcinoma could be significantly differentiated from endometrial carcinoma by MB. The staining in endocervical adenocarcinoma and endometrial carcinoma was predominantly present in both apical and cytoplasmic locations compared to their non-neoplastic counterparts (endocervix, p = 0.003; endometrium, p = 0.049).
  
  
  CONCLUSIONS
  This study showed that a panel of histochemical stains could differentiate glandular cells of endocervical epithelium from endometrium.
authors.affiliation: Department of Pathology, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Nieuwenhuizen
authors.forename: Mohd K
authors.initials: MK
authors.lastname: Khalil
authors.forename: Naik
authors.initials: N
authors.lastname: Venkatesh
authors.forename: Nor Hayati
authors.initials: NH
authors.lastname: Othman
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis; D002584:Cervix Uteri / Q000378:metabolism* / Q000473:pathology; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D004717:Endometrium / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D009077:Mucins / Q000737:chemistry; D010503:Periodic Acid-Schiff Reaction / Q000379:methods; D013194:Staining and Labeling; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*
chemical_list: D014408:Biomarkers, Tumor; D009077:Mucins