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Cell Block Preparation from Cytology Specimen with Predominance of Individually Scattered Cells
Published on: July 21, 2009
Immunocytochemistry of serous effusion specimens: a comparison of ThinPrep vs cell block
Yun Gong1, Xiaoping Sun, Claire W Michael
1Department of Cytopathology, Northwestern University Medical School, Chicago, Illinois 60611-2908, USA.
Insights
ThinPrep and cell-block preparations yield similar immunocytochemical results for most markers in effusion samples. However, cell blocks offer superior performance for nuclear markers like Ki67, PCNA, and p53.
Area of Science:
- Cytopathology
- Immunohistochemistry
- Molecular Diagnostics
Background:
- The ThinPrep Processor is increasingly used for gynecologic and nongynecologic cytologic samples, including effusions.
- Immunocytochemistry is crucial for diagnosing effusion specimens, but preparation methods may impact results.
Purpose of the Study:
- To compare immunocytochemical staining results between ThinPrep and cell-block preparations from effusion specimens.
- To evaluate the utility of common antibodies used in effusion cytopathology on both preparation types.
Main Methods:
- Effusion samples (17 reactive, 79 metastatic adenocarcinomas) were processed as ThinPrep slides and cell blocks.
- Slides were immunostained for intermediate filaments, cytoplasmic/membrane proteins, and nuclear antigens using identical avidin-biotin protocols.
Main Results:
- Both ThinPrep and cell blocks showed comparable results for non-nuclear markers (cytokeratins, vimentin, EMA, CEA, B72.3, BerEP4) in terms of positivity, intensity, and distribution.
- Significantly lower frequency and intensity of reaction were observed for nuclear markers (Ki67, PCNA, p53) with ThinPrep compared to cell blocks, especially in malignant effusions.
Conclusions:
- ThinPrep and cell-block preparations provide similar immunocytochemical data for most markers in effusion analysis.
- Cell-block preparations are superior to ThinPrep for evaluating nuclear markers (Ki67, PCNA, p53) in effusion cytology.
Abstract:
The ThinPrep Processor is gaining popularity in both gynecologic and nongynecologic cytologic samples, including effusion specimens. We compared immunocytochemical results on ThinPrep and cell-block preparations from the same effusion specimen with antibodies commonly used in effusion cytopathology. Samples from 17 reactive effusions and 79 effusions with metastatic adenocarcinomas were each prepared as monolayer ThinPreps and formalin-fixed, paraffin-embedded cell blocks. All slides were immunostained with antibodies against intermediate filaments (cytokeratins 8 and 18, and vimentin), cytoplasmic or membrane proteins (EMA, polyclonal CEA, B72.3, and BerEP4), and nuclear antigens (Ki67, PCNA, and p53), using the avidin-biotin procedure. ThinPrep and cell-block slides were stained simultaneously, using identical protocols. Both preparations showed similar results with respect to frequency of positivity, intensity, and distribution of stain for all nonnuclear markers tested. However, for the three nuclear markers Ki67, PCNA, and p53, the frequency and intensity of reaction with ThinPrep were significantly lower than with the cell-block preparation, particularly in malignant effusions. These findings suggest that immunocytochemical results obtained with ThinPrep match those of cell block for most markers tested. However, cell-block preparation are superior to ThinPrep for nuclear markers (Ki67, PCNA, and p53).
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