Flow Cytometry of Peritoneal Washings in Gynecologic Neoplasia

Lovecchio, John L.; Budman, Daniel R.; Susin, Myron; Grueneberg, Denise; Fenton, Arnold N.

doi:10.1097/00006250-198605000-00014

Cited by 12 publications

(11 citation statements)

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“…In the absence of a strict definition of what is aneuploid, it is not difficult to understand the conflicting reports about the usefulness of DNA flow cytometry for evaluation of BCF. Lovecchio et al 1 used the ratio of mean fluorescence between the internal standard and the normal cells in a test sample to calculate the mean and standard deviation. Their definition of aneuploidy was any ratio greater than normal ratio plus two standard deviations.…”

Section: Discussionmentioning

confidence: 99%

“…In one of the earlier studies, flow cytometric analysis of body cavity fluids with negative cytology found cells with aneuploid DNA content and on re-examination these samples were found to be cytologically positive, thus reducing the false-negative rate from 21.8% to 4.7%. 1 Some other studies reported that DNA flow cytometry was in general less sensitive than cytology for the detection of malignant cells and a higher percentage of falsepositive cases were seen by flow analysis. Based on these reports, it was generalized that DNA flow analysis did not offer any advantages over cytomorphology for the detection of malignant cells in body cavity fluids.…”

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Detection of tumor cells in body cavity fluids by flow cytometric and immunocytochemical analysis

et al. 2006

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Measurement of electronic volume versus DNA content of nuclei can be used to discriminate between normal and malignant cells. Epithelial membrane antigen immunocytochemistry (EMA-ICC), a helpful ancillary test in body cavity fluids, is not universally accurate for detecting malignancy in effusions. The current study was undertaken to determine if multiparametric flow cytometry (based on simultaneous analysis of light scatter, nuclear volume, DNA, and nuclear protein content) in combination with (EMA-ICC) could be used for the detection of malignant cells in peritoneal and pleural fluids. We studied 130 body cavity fluids (68 peritoneal and 62 pleural fluids) by conventional cytology and multiparametric laser flow cytometry. EMA-ICC was performed using EMA antibodies and L-SAB detection system (DakoCytomation, Carpinteria, CA). EMA-ICC had significantly higher sensitivity than conventional cytology (79% versus 59%, P = 0.016) and ploidy (79% versus 38%, P = 0.001). Cytology had significantly higher specificity than ploidy (97% versus 82%, P = 0.012). The differences in specificity between EMA-ICC and ploidy (87% versus 82%, P= 0.607) or EMA-ICC and cytology (87% versus 97%, P = 0.109) were not statistically significant. However, assuming serial testing, sensitivity increased significantly for the combinations of cytology and EMA-ICC (79.4%, P = 0.016) and cytology and ploidy (73.5%, P = 0.004) as compared to cytology alone (58.8%). Also, the combination of cytology and ploidy had a higher sensitivity than ploidy alone (73% versus 38%, P < 0.0001). However, the sensitivity associated with the three tests used in serial (85.3%) was not significantly different from the sensitivities corresponding to the combination of cytology and EMA-ICC (79%) or cytology and ploidy (73%). Multiparametric flow cytometry utilizing high resolution DNA, nuclear volume, protein measurement, and ICC, in combination with cytomorphology, may be a valuable tool for rapid identification of malignant cells in body cavity fluids.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Detection of tumor cells in body cavity fluids by flow cytometric and immunocytochemical analysis

et al. 2006

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“…The reported rates of concordance between cytometric and cytologic methods in gynaecological malignancies vary. The largest comparative series in gynaecological cancers (Lovecchio et al 1986) involved 194 patients with heterogeneous pathologies (74 ovarian cancer) and reported a correlation of 84.5% with cytological findings. Aneuploid cells were detected in 28/128 specimens which were cytologically negative (a false positive rate of 21.8%), although 22 of these had unequivocal evidence of malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…Flow cytometry is quick and accurate, capable not only of detecting abnormal cellular DNA ploidy content, but also information on cell kinetic and biological behaviour. Potentially, it can augment the knowledge obtained from Correspondence: Dr S. Kehoe,Department of Obstetrics and Gynaecology,City Hospital,Dudley Road,Birmingham B18 7QH,UK. cytological assessment, but few reports are available addressing its diagnostic potential in peritoneal fluids from ovarian cancer patients (Lovecchio et al 1986;Rotmensch et al 1992).…”

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The application of flow cytometric DNA analysis in detecting the presence of malignant cells in ovarian carcinoma peritoneal fluids

Kehoe

Ward

Luesley

et al. 1995

BJOG

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Objective To compare flow cytometric detection of malignant cells with standard cytological evaluation in patients with ovarian carcinoma. Setting The City Hospital Trust, The Women's Hospital and CRC Trials Unit, Birmingham. Subjects Forty‐three patients with histologically proven ovarian carcinoma and positive cytology, and a control population of 20 patients undergoing surgery for benign gynaecological conditions. Methods Prospective, blinded study examining ascitic fluid or peritoneal washings obtained at primary surgery by flow cytometric DNA analysis and cytological examination. Results Flow cytometry detected aneuploid cells in 27/43 (63%) of malignant and 7/20 (35%) of benign fluid specimens. In malignant samples the mean aneuploid count was 38.5% (range 1–98%) with a mean S‐phase fraction of 5.2% (range 0–33.9%). In benign specimens the mean aneuploid count was 30.4% (range 14.5–66.4%). Based on these results, the overall sensitivity of cytometric detection of malignant cells was 714Y0, specificity 65%, with a positive predictive value of 85.1%. False positivity was found mainly in patients with benign ovarian cysts. Further examination revealed four false negative and four false positive results, where the peritoneal fluid and ovarian tissue DNA ploidy status concurred. Assuming such results to be correct increased the sensitivity of the test to 88.5YO and specificity to 85%. Conclusions Although flow cytometry can glean information beyond the capabilities of cytological assessment, using the premise that aneuploid cells alone indicate malignancy, it remains secondary to cytology in the detection of malignant cells in peritoneal fluids.

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“…Furthermore, serum CA 125 levels may be normal in the presence of microscopic disease (Welander et al 1988). It has been suggested that flow cytometric DNA analysis is an accurate method for the detection of malignant cells within peritoneal washings and may augment cytological examination (Lovecchio et al 1986;Sinton eta/. 1990).…”

Section: Discussionmentioning

confidence: 99%

The treatment of microscopic residual ovarian cancer with intraperitoneal interferon: a clinical and flow cytometric study

Whelan¹,

Dam²,

Shepherd³

et al. 1992

BJOG

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Flow Cytometry of Peritoneal Washings in Gynecologic Neoplasia

Cited by 12 publications

References 0 publications

Detection of tumor cells in body cavity fluids by flow cytometric and immunocytochemical analysis

Detection of tumor cells in body cavity fluids by flow cytometric and immunocytochemical analysis

The application of flow cytometric DNA analysis in detecting the presence of malignant cells in ovarian carcinoma peritoneal fluids

The treatment of microscopic residual ovarian cancer with intraperitoneal interferon: a clinical and flow cytometric study

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