DNA Ploidy and Proliferating Cell Nuclear Antigen Image Analysis of Peritoneal and Pleural Effusions

El-Habashi, Ahmed; Freeman, Scott; B, el-Morsi; EL-Didi, Munir; Martin, Andrew; Marrogi, Aizen J.

doi:10.1159/000332677

Cited by 8 publications

(13 citation statements)

References 29 publications

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“…Using this cut off value, the sensitivity and specificity for diagnosis of effusion were 83.3% and 100%, respectively. The sensitivity and specificity of our study are similar to the 75-88% sensitivity and high specificity reported by previous studies using manual DNA ICM for effusion diagnosis [19,25,27]. Our study showed that automated DNA ICM could be applied to effusion cytology diagnosis with similar diagnostic accuracy as compared to manual ICM.…”

Section: Discussionsupporting

confidence: 87%

“…Motherby et al [25] measured DNA ploidy in 200 effusion cytology specimens and found that the sensitivity and specificity were 75% and 100% by ICM but were 32.1% and 100% by flow cytometry. By using ICM for quantification of DNA aneuploidy, several other studies showed that DNA aneuploidy was more sensitive than conventional cytology for detection of malignant cells in effusion specimen [19,26,27]. El-Habashi et al [27] reported that sensitivity, Table 3 Diagnostic accuracy using DNA ploidy diagnostic threshold values of different kinds of cytologic specimens DNA ploidy (c) Cell numbers Sensitivity Specificity PPV NPV specificity, PPV and NPV of DNA ploidy and conventional cytology were 85% vs. 65%, 94% vs. 100%, 96% vs. 100% and 80% vs. 62% in 87 consecutive effusion specimens.…”

Section: Discussionmentioning

confidence: 99%

“…By using ICM for quantification of DNA aneuploidy, several other studies showed that DNA aneuploidy was more sensitive than conventional cytology for detection of malignant cells in effusion specimen [19,26,27]. El-Habashi et al [27] reported that sensitivity, Table 3 Diagnostic accuracy using DNA ploidy diagnostic threshold values of different kinds of cytologic specimens DNA ploidy (c) Cell numbers Sensitivity Specificity PPV NPV specificity, PPV and NPV of DNA ploidy and conventional cytology were 85% vs. 65%, 94% vs. 100%, 96% vs. 100% and 80% vs. 62% in 87 consecutive effusion specimens. Motherby et al [19] reported that DNA aneuploidy defined by the presence of 9c cells or variation of the first DNA stemline by ≥10% has 100% PPV for adenocarcinoma and mesothelioma and 100% NPV for adenocarcinoma and 88% NPV for mesothelioma.…”

Section: Discussionmentioning

confidence: 99%

“…Even in equivocal cases, sensitivity and specificity of DNA aneuploidy were 55.9% and 94.1%, respectively [26]. However, almost all of the previous studies used manual measurement of DNA ploidy [19,24,26,27]. Manual ICM is time consuming, subject to sampling error, and has to be done by an experienced cytopathologist.…”

Section: Discussionmentioning

confidence: 99%

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Automated Quantification of DNA Aneuploidy by Image Cytometry as an Adjunct for the Cytologic Diagnosis of Malignant Effusion

Meng

Shi

Zhu³

et al. 2013

Analytical Cellular Pathology

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Abstract. DNA aneuploidy is a cancer biomarker, which may have a potential diagnostic value in body effusion specimen. DNA aneuploidy is determined by measuring the DNA content of tested cells and comparing them with diploid cells (2c). In order to assess the value of automated DNA image cytometry (DNA-ICM) in the cytologic diagnosis of effusion, we measured DNA ploidy using an automated DNA-ICM analysis system in 126 consecutive effusion specimens and followed the cases for histologic diagnosis. Half of each effusion specimen was used to prepare cytologic smears for conventional cytologic diagnosis, while the other half was used to prepare a monolayer slide stained by Feulgen stain for automated ICM. By using Youden index, we found that 4 cells exceeding 2.5c is the optimal cut off value for aneuploidy, which has a sensitivity of 88.3% and specificity of 100% for diagnosis of malignant effusion. We also found that the DNA aneuploidy thresholds used for other types of cytologic specimens cannot be used in the diagnosis of effusion specimens. Our study demonstrated that automated DNA image cytometry is a simple, practical and cost-effective method for adjunct diagnosis of malignant effusion.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Automated Quantification of DNA Aneuploidy by Image Cytometry as an Adjunct for the Cytologic Diagnosis of Malignant Effusion

Meng

Shi

Zhu³

et al. 2013

Analytical Cellular Pathology

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“…8 Only a few of these antibodies have been investigated in effusion cytology. [9][10][11] RNR is a key enzyme in the synthesis of deoxyribonucleotide from ribonucleotides. 12 This enzyme is composed of two nonidentical subunits, R1 and R2, which are differentially regulated during the cell cycle.…”

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confidence: 99%

Ribonucleotide Reductase Immunoreactivity in Adenocarcinoma Cells and Malignant or Reactive Mesothelial Cells in Serous Effusions

et al. 2003

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Value of Ki67 immunostain in identification of malignancy in serous effusions

1999

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The distinction between malignant and benign serous effusions continues to be a challenging and a frequent problem to cytopathologists. Recently, immunostains employing various antibodies have improved the diagnostic accuracy of malignant effusions. We investigated the usefulness of Ki67 (MIB1) antigen immunostaining in the evaluation and diagnosis of malignant serous effusions. Cell block sections from a total of 54 cases of serous effusions cytologically diagnosed as malignant (28), suspicious (6), and benign (20) were immunostained with MIB1 monoclonal antibody to the Ki67 nuclear proliferation antigen according to the avidin‐biotin immunoperoxidase method. The patients were 30 women and 24 men with an average age of 58 yr. Ki67 (MIB1) immunostain labeling index (LI) values were higher than 20% in 23 of 28 (82%) cytologically malignant, in 3 of 6 (50%) suspicious, and in 1 of 20 (5%) benign/reactive. Further investigation revealed histologic, radiologic, and/or clinical evidence of malignancy in the 3 suspicious (but not in the benign/reactive) cases with Ki67 LI values higher than 20%. Correlation between Ki67 LI (>20%) and cytologic effusion type (benign, suspicious, or malignant) was statistically significant (P < 0.0001). Ki67 immunostaining has value as an adjunct testing to cytomorphology and other immunostains in distinguishing benign from malignant effusions. The addition of Ki67 immunostaining to conventional cytology appears more sensitive than cytomorphology alone and may assist in arriving at accurate diagnoses in suspicious cases with inconclusive cytomorphologic features. Diagn. Cytopathol. 1999;20:24–28. © 1999 Wiley‐Liss, Inc.

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DNA Ploidy and Proliferating Cell Nuclear Antigen Image Analysis of Peritoneal and Pleural Effusions

Cited by 8 publications

References 29 publications

Automated Quantification of DNA Aneuploidy by Image Cytometry as an Adjunct for the Cytologic Diagnosis of Malignant Effusion

Automated Quantification of DNA Aneuploidy by Image Cytometry as an Adjunct for the Cytologic Diagnosis of Malignant Effusion

Ribonucleotide Reductase Immunoreactivity in Adenocarcinoma Cells and Malignant or Reactive Mesothelial Cells in Serous Effusions

Value of Ki67 immunostain in identification of malignancy in serous effusions

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