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Immunocytochemical staining of serous effusions with the monoclonal antibody Ber-EP4
M De Angelis1, I D Buley, A Heryet
1Cellular Pathology Department, John Radcliffe Hospital, Oxford, England.
Insights
Ber-EP4 antibody is a valuable tool for diagnosing adenocarcinoma in serous effusions. It accurately distinguishes adenocarcinoma cells from benign mesothelial cells, aiding in differential diagnosis.
Area of Science:
- Cytopathology
- Immunohistochemistry
- Oncology
Background:
- Serous effusions can contain adenocarcinoma or mesothelial cells, requiring accurate differentiation for diagnosis.
- Distinguishing between adenocarcinoma and malignant mesothelioma in effusions is clinically significant.
Purpose of the Study:
- To evaluate the utility of a new monoclonal antibody, Ber-EP4, in differentiating adenocarcinoma from mesothelial cells in serous effusions.
- To assess the diagnostic performance of Ber-EP4 compared to other markers like CEA, EMA, Ca2, and CD15.
Main Methods:
- Immunocytochemical staining was performed on 102 serous effusion samples.
- A panel of monoclonal antibodies, including Ber-EP4, was used.
- Cytological examination identified tumor cells, benign cells, or suspicious cells.
Main Results:
- Ber-EP4 showed 100% positive staining in adenocarcinoma cells (32 cases) and no staining in benign or malignant mesothelial cells.
- Other markers (CEA, EMA, Ca2, CD15) showed variable positivity in adenocarcinoma cells.
- Ber-EP4 demonstrated high specificity for adenocarcinoma cells.
Conclusions:
- Ber-EP4 is a highly effective antibody for the differential diagnosis of adenocarcinoma versus mesothelial cells in serous effusions.
- Ber-EP4 is a valuable addition to the immunocytochemical panel for effusion analysis.
- This antibody aids in accurate diagnosis and patient management.
Abstract:
Cytospin preparations were made from 102 serous effusions for immunocytochemical staining using a panel of monoclonal antibodies including a new monoclonal antibody Ber-EP4. On cytological examination, 32 fluids were reported to contain tumour cells consistent with metastatic adenocarcinoma; 66 contained benign cells only and three were reported to contain cells suspicious of malignancy. One effusion contained tumour cells consistent with malignant mesothelioma. Positive staining of the tumour cells with Ber-EP4 was observed in the 32 effusions (100%) which contained adenocarcinoma cells. No staining of the mesothelial cells in these 32 specimens was observed. Carcinoembryonic antigen, epithelial membrane antigen Ca2 and CD15 staining of tumour cells was noted in 53%, 50%, 50% and 9% of these cases, respectively. None of the mesothelial cells in the benign effusions stained with Ber-EP4. Nor did the malignant mesothelial cells in the only case of malignant mesothelioma. These findings suggest that Ber-EP4 is a valuable addition to antibodies available for the differential diagnosis of mesothelial cells and adenocarcinoma cells in serous effusions.