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Cytophotometric determination of DNA in mesotheliomas and reactive mesothelial cells
M A Hafiz1, R L Becker, U V Mikel
1Department of Pathology, University of Maryland School of Medicine, Baltimore.
Abstract:
Cytophotometry was used to study the nuclear DNA content of cells in Feulgen-stained effusion specimens from 18 patients with mesothelioma and 14 patients with reactive mesothelial proliferations. The mean DNA content (MDNA) of mesothelioma cells was significantly higher than that of reactive mesothelial cells (P less than .001). Other parameters reflecting the DNA content also differed significantly between the two kinds of cells, including (1) the ratio of mean mesothelial DNA to mean lymphocyte DNA, (2) the percentage of mesothelial cells with DNA content exceeding three times the lymphocyte MDNA and (3) the coefficient of variation of the DNA content. Since these parameters were highly correlated, only one was accepted in a stepwise linear discriminant model for distinguishing reactive from mesotheliomatous effusions. The model correctly classified all of the reactive effusions studied and 89% of the mesotheliomatous effusions. These results indicate that DNA analysis, using the Feulgen stain and cytophotometry, yields criteria that may be useful in distinguishing benign reactive mesothelial cells from malignant mesothelioma in effusions when used in conjunction with other traditional parameters.
Insights
DNA analysis using Feulgen stain and cytophotometry can distinguish malignant mesothelioma from benign reactive mesothelial cells in effusions. This method offers valuable criteria for accurate diagnosis.
Area of Science:
- Oncology
- Cytopathology
- Biomedical Imaging
Background:
- Distinguishing malignant mesothelioma from reactive mesothelial proliferations in effusions is diagnostically challenging.
- Accurate differentiation is crucial for appropriate patient management and treatment.
Purpose of the Study:
- To evaluate the utility of nuclear DNA content analysis via cytophotometry in differentiating mesothelioma from reactive mesothelial cells.
- To establish quantitative criteria for improved diagnostic accuracy in effusion cytology.
Main Methods:
- Feulgen staining of effusion specimens from patients with mesothelioma and reactive mesothelial proliferations.
- Quantitative DNA content analysis using cytophotometry.
- Statistical analysis including discriminant modeling to identify differentiating parameters.
Main Results:
- Mesothelioma cells exhibited significantly higher mean DNA content (MDNA) compared to reactive mesothelial cells (P < .001).
- Other DNA-related parameters, including DNA/lymphocyte ratio and percentage of cells with high DNA content, also differed significantly.
- A discriminant model correctly classified 100% of reactive effusions and 89% of mesothelioma effusions.
Conclusions:
- Nuclear DNA content analysis by Feulgen cytophotometry provides reliable criteria for distinguishing mesothelioma from reactive mesothelial proliferations.
- This quantitative method, when combined with traditional parameters, enhances diagnostic accuracy in effusion cytology.
- DNA ploidy analysis offers a valuable adjunct for the definitive diagnosis of mesothelioma.