Immunohistochemical Panel for Distinguishing Between Carcinoma and Reactive Mesothelial Cells in Serous Effusions

Lee, Ji Shin; Nam, Jong Hee; Lee, Min Cheol; Park, Chang Soo; Juhng, Sang Woo

doi:10.1159/000333930

Cited by 29 publications

(37 citation statements)

References 9 publications

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“…CEA was often used in immunohistochemical studies to distinguish carcinoma cells from reactive mesothelial or mesothelioma cells (14,28). However, it was never used as a RT-PCR marker in serous effusions.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Panel of Molecular Markers for the Diagnosis of Malignant Serous Effusions

Passebosc-Faure

Lambert

et al. 2005

Clinical Cancer Research

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Purpose: Our main goal was to evaluate a panel of molecular markers for the detection of cancer cells in serous effusions and to determine their value as an adjunctive reverse transcription-PCR (RT-PCR) test to cytologic examination. Experimental Design: One hundred fourteen serous effusions from 71patients with tumors and 43 patients with benign diseases were subjected to RT-PCR for expression of carcinoembryonic antigen (CEA), epithelial cell adhesion molecule (Ep-CAM), E-cadherin, mammaglobin, mucin 1 (MUC1) isoforms MUC1/REP, MUC1/Y, and MUC1/Z, calretinin, and Wilms' tumor 1susceptibility gene. Results: CEA, Ep-CAM, E-cadherin, and mammaglobin were specifically expressed in malignant effusions. The sensitivity of RT-PCR in cytologically negative malignant effusions was 63.1% combining CEA and Ep-CAM (with 100% specificity) and reached 78.9% adding MUC1/Y or MUC1/Z (with 93% specificity). In the whole population of effusions, the combination of cytology with RT-PCR of CEA and Ep-CAM yielded a 90.1% sensitivity, a specificity and a positive predictive value of 100%, and a 86% negative predictive value for malignancy. Adding MUC1/Y or MUC1/Z to the panel, the sensitivity was 94.5% with 93% specificity, 95.7% PPV, and 90.9% negative predictive value. Moreover, CEA and mammaglobin were specifically expressed in epithelial malignancies, and mammaglobin was mainly expressed in effusions from breast carcinoma (97.3% of specificity). Conclusions: A combination of cytology and RT-PCR analysis of CEA and Ep-CAM significantly improved the detection sensitivity of tumor cells in serous effusions. RT-PCR analysis of CEA, Ep-CAM, and mammaglobin in serous effusions could be a beneficial adjunct to cytology for the diagnosis of malignancy.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a Panel of Molecular Markers for the Diagnosis of Malignant Serous Effusions

Passebosc-Faure

Lambert

et al. 2005

Clinical Cancer Research

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“…(J Clin Pathol 2001;54:831-835) Keywords: ascitic fluid; carcinoembryonic antigen; cholesterol; cytology Conventional cytological examination of ascitic fluid often yields inconclusive results: apart from benign and malignant diagnoses, many cases are "suspicious for malignancy". [1][2][3] In liver cirrhosis, inflammation, chemotherapy, and irradiation it is often diYcult to distinguish exfoliated reactive mesothelial cells from highly diVerentiated cancer cells. Moreover, the cytology is often false negative because only a few neoplastic cells are present in the fluid, 4 or processing of specimens is suboptimal with lysis of tumour cells.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] In liver cirrhosis, inflammation, chemotherapy, and irradiation it is often diYcult to distinguish exfoliated reactive mesothelial cells from highly diVerentiated cancer cells. Moreover, the cytology is often false negative because only a few neoplastic cells are present in the fluid, 4 or processing of specimens is suboptimal with lysis of tumour cells.…”

mentioning

confidence: 99%

Value of carcinoembryonic antigen (CEA) and cholesterol assays of ascitic fluid in cases of inconclusive cytology

Gulyás

Kaposi

Elek³

et al. 2001

Journal of Clinical Pathology

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Aim-To determine whether assays of carcinoembryonic antigen (CEA) and cholesterol in ascites add diagnostic value to cytology. Methods-The additional diagnostic eYcacy of the biochemical assays was studied in the ascitic fluid from 130 patients, of whom 57 had peritoneal carcinomatosis. All diagnoses were verified by subsequent necropsy and/or histology. Results-CEA concentrations over 5 ng/ ml indicated carcinomas, occasionally without peritoneal involvement of the tumour. However, increased values were significantly more common in cancer with peritoneal involvement (p < 0.01), giving a sensitivity of 51% and specificity of 97% for carcinomatosis. A cholesterol value exceeding 1.21 mmol/litre was found in 93% of cancers with peritoneal involvement, but it was not entirely specific (96%) for carcinomatosis. Simultaneous increases in CEA and cholesterol concentrations were specific for carcinomatosis and this combination increased the sensitivity for diagnosing carcinomatosis from 77% with cytology alone to 88%. The correct diagnosis could thus be made in five of 12 cases with inconclusive cytology. Conclusions-The measurements of both CEA and cholesterol concentrations in ascites give additional specific information about peritoneal carcinomatosis and can therefore be a useful adjunct to cytology-in particular, in inconclusive cases. (J Clin Pathol 2001;54:831-835) Keywords: ascitic fluid; carcinoembryonic antigen; cholesterol; cytology Conventional cytological examination of ascitic fluid often yields inconclusive results: apart from benign and malignant diagnoses, many cases are "suspicious for malignancy". [1][2][3] In liver cirrhosis, inflammation, chemotherapy, and irradiation it is often diYcult to distinguish exfoliated reactive mesothelial cells from highly diVerentiated cancer cells. Moreover, the cytology is often false negative because only a few neoplastic cells are present in the fluid, 4 or processing of specimens is suboptimal with lysis of tumour cells. 5 Therefore, a specific cytological diagnosis may have a sensitivity of only 40-80%. [6][7][8] Samples that are inconclusive because of some cellular atypia can be further evaluated with ancillary morphological methods, such as immunocytochemistry 1-3 9 and DNA cytometry, 2 9 10 although these techniques are of little help when only a few preserved tumour cells are present.Biochemical parameters, such as the concentrations of carcinoembryonic antigen (CEA) 6-8 10-12 and cholesterol 4 12-15 in the serous eVusion, have been studied as markers of malignancy. Such assays can be done rapidly in properly preserved eVusions after cytological examination, but their diagnostic value is still debated. It has therefore been stated that the cholesterol content of ascitic fluid is neither specific nor sensitive for a tumour.5 16 Some authors have suggested that a high concentration of CEA in the ascitic fluid is indicative of peritoneal metastases from a CEA producing tumour, 7 12 although it has been found in carcinomas without serosal involvement....

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“…8,26,33 The application of immunohistochemistry using panels has been promoted as a tool to enhance the detection of malignant cells in serous effusions. 1,19,21 Nevertheless, no single antibody has emerged that is capable of consistently detecting malignant cells. Recently immunohistochemical determination of oncogenes was successfully employed to increase diagnostic sensitivity in serous effusions.…”

Section: Discussionmentioning

confidence: 99%

“…Final cytologic diagnoses were made by a combination of cytology and immunohistochemistry using antibodies against cytokeratin, carcinoembryonic antigen, epithelial membrane antigen and fibronectin. 19 …”

Section: Methodsmentioning

confidence: 99%

Diagnostic Value of p53 Protein and Flow Cytometric DNA Analysis in the Study of Serous Effusions

Lee¹,

Lee²,

Park³

et al. 1997

Acta Cytologica

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Immunohistochemical Panel for Distinguishing Between Carcinoma and Reactive Mesothelial Cells in Serous Effusions

Cited by 29 publications

References 9 publications

Evaluation of a Panel of Molecular Markers for the Diagnosis of Malignant Serous Effusions

Evaluation of a Panel of Molecular Markers for the Diagnosis of Malignant Serous Effusions

Value of carcinoembryonic antigen (CEA) and cholesterol assays of ascitic fluid in cases of inconclusive cytology

Diagnostic Value of p53 Protein and Flow Cytometric DNA Analysis in the Study of Serous Effusions

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