Immunocytochemistry in the differential diagnosis of serous effusions - A comparative evaluation of eight monoclonal antibodies in Papanicolaou stained smears

Citation
Md. Lozano et al., Immunocytochemistry in the differential diagnosis of serous effusions - A comparative evaluation of eight monoclonal antibodies in Papanicolaou stained smears, CANC CYTOP, 93(1), 2001, pp. 68-72
Citations number
23
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
CANCER CYTOPATHOLOGY
ISSN journal
0008-543X → ACNP
Volume
93
Issue
1
Year of publication
2001
Pages
68 - 72
Database
ISI
SICI code
0008-543X(20010225)93:1<68:IITDDO>2.0.ZU;2-E
Abstract
BACKGROUND. The distinction between pleural mesothelioma (MS), reactive mes othelium (RM), and adenocarcinoma (AC) in serous effusions continues as a d iagnostic problem in pathology. Immunohistochemistry can help, especially i n surgical samples, but the optimum panel of antibodies has yet to be repor ted. The application of these antibodies to serous effusions has displayed variable results. The aim of this study Was to evaluate the usefulness of e ight monoclonal antibodies in the differential diagnosis of MS, RM, and AC in serous effusions. METHODS. A total of 44 cytologic specimens of serous effusions (26 pleural, 15 peritoneal, and 3 pericardial) from 30 ACs, 3 MSs, and 11 RMs, previous ly stained with Papanicolaou stain, were selected retrospectively from our files and stained with HBME-1, thrombomodulin, calretinin, MOC-31, Ber-EP4 E-cadherin, CEA, and CD-15. The immunoreactions were evaluated independentl y by two pathologists. A stepwise logistic regression analysis was applied to the data to select an appropriate panel of antibodies. RESULTS. Statistical significance was found with HBME-1, thrombomodulin, MO C-31, Ber-EP4, and CD-15, when comparing both AC versus MS, and PLC versus any type of mesothelial proliferation CMS or RM). Using HBME-1, 80% of ACs were negative whereas all three MSs reacted strongly with P = 0.003. A P = 0.02 was reached with thrombomodulin with 76.5% of ACs showing no immunorea ctivity. Ber-EP4 and MOC-31 displayed good results with a P < 0.001 and 0.0 1, respectively. CD-15 reached a P = 0.034. No differences were found using the other antibodies. Ten ACs, all 3 MSs, and 10 RMs were double immunosta ined with HBME-1 and/or MOC-31 and Ber-EP4 successfully. CONCLUSIONS. Immunohistochemical studies performed on Papanicolaou stained cytologic smears proved to be useful in the differentiation between metasta tic AC and mesothelial proliferation. HBME-1, thrombomodulin, MOC-31, Ber-E P4, and CD-15 were the most useful. In selected cases, it appeared that dou ble immunostaining aided the differential diagnosis. Cancer (Cancer Cytopat hol) 2001;93:68-72, (C) 2001 American Cancer Society.