Detection of cancer cells in effusions from patients diagnosed with gynaecological malignancies

Abstract

The detection of malignant cells in pleural, peritoneal, and pericardial fluids of cancer patients marks the presence of metastatic disease and is associated with a grave prognosis. We evaluated five epithelial markers for the detection of cancer cells in 94 fresh pleural, peritoneal and pericardial effusions. Eighty-four of the samples were regarded as adequate for analysis after evaluation of cytological smears, including 61 samples from patients known to have gynaecological neoplasms. The other 23 samples were from patients with various non-gynaecological malignancies or tumours of unknown origin. Our control cases were 10 fallopian tubes not affected by any malignancy and 12 malignant mesotheliomas. Cell blocks from all cases were stained for CA-125, BerEP4, carcinoembryonic antigen (CEA), BG8 (Lewis Y blood antigen), and B72.3 (TAG-72). Fifty-one of 84 cases were diagnosed as malignant or suggestive of malignancy in cytological smears and/or cell block sections. However, staining for epithelial markers highlighted the presence of malignant cells in 7 additional cases. When membrane staining was evaluated, the sensitivity of the markers studied in detecting malignant cells was as follows: CA-125: 88%, BerEP4: 78%, CEA: 26%, BG8: 86%, B72.3: 79%. Membrane positivity for CEA, B72.3 and BerEP4 was not detected in reactive mesothelial cells. However, membranous staining in mesothelial cells was evident in 13% and 31% of cases with the use of BG8 and CA-125, respectively. Weak cytoplasmic staining for CEA was observed in mesothelial cells in 2 cases. When Ber-EP4, B72.3, and BG8 staining results in cancer cells were combined, the following sensitivity levels were observed: BG8+B72.3: 91%; BG8+Ber-EP4: 90%; B72.3+Ber-EP4: 93%; BG8+Ber-EP4+B72.3: 95%. The detection of malignant cells in effusions is facilitated by the use of immunocytochemistry using a wide panel of antibodies. BerEP4 and B72.3 appear to be the best markers when both sensitivity and specificity are considered, followed by BG8, while CEA and CA-125 have a limited role in the detection of metastases from gynaecological tumours owing to the low sensitivity of the former and the low specificity of the latter. Analysis of all staining results should be based on a thorough morphological examination.

Altered Expression of Metastasis-Associated and Regulatory Molecules in Effusions from Breast Cancer Patients

“…Additional material was suspended and frozen in equal volumes of RPMI 1640 supplemented with 20% fetal calf serum and 20% dimethyl sulfoxide. Smears and cell block sections from all specimens underwent morphologic evaluation by experienced cytopathologists and were further characterized using immunocytochemistry with broad antibody panels against cancer and mesothelial epitopes, as detailed previously (36,37 (38 -43): MMP-2, 5Ј-TGGGCTACGGCGCGGCGGCGTGGC-3Ј; MMP-9, 5Ј-CC-GGTCCACCTCGCTGGCGCTCCGGU-3Ј; TIMP-2, 5Ј-CCAG-GAGGGATGTCAGAGC-3Ј; EMMPRIN, 5Ј-CAGCGCGAATC-CCAGCAGCACGAAC-3Ј; 67-kDa LR, 5Ј-GTGAGCTCCCTTG-TTGTTGCA-3Ј; ␣ 6 integrin subunit, 5Ј-AGACTCCGTTAGGT-TCAGGGA-3Ј; PEA3, 5Ј-TGAATTATGAGAAGCTGAGCCG-3Ј; and Ets-1, 5Ј-GCCCAGCTTCATCACAGAGTCCTATCAG-AC-3Ј. The specificity of the probes was verified using sense probes (Research Genetics).…”

Granulin‐epithelin precursor is a novel prognostic marker in epithelial ovarian carcinoma

“…Smears and cell block sections from formalin-fixed, paraffin-embedded pellets underwent diagnostic morphologic evaluation by three experienced cytopathologists, and then were characterized further using immunocytochemistry with broad antibody panels against carcinoma, mesothelial, and leukocyte epitopes, as previously detailed. [15][16][17] Fixation and block preparation procedures were identical to those employed for biopsy specimens. One hundred eighty-nine surgical specimens from 78 patients (74 patients with ovarian carcinoma, 3 with PPC, and 1 with carcinoma of the fallopian tube) were studied.…”

Lysis of cancer cells by autologous T cells in breast cancer pleural effusates treated with anti-EpCAM BiTE antibody MT110

“…Although, MPEs are well characterized [6][7][8][9][10][11][12][13][14], the knowledge gathered by in vitro and in vivo studies, translated only into a few novel therapeutic strategies for clinical testing [15][16][17]. Thus, there is still a significant need for effective treatment strategies for the management of MPEs.…”