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Published on: July 21, 2009
Modified Liquid-Based Cytology Technique for Immunocytochemistry in Effusion Specimen
Natcha Patarapadungkit1, Porntip Jangsiriwitayakorn1, Surachat Chaiwiriyakul1
1Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Insights
A modified liquid-based cytology technique enhances immunocytochemistry for serous effusions. This method effectively differentiates metastatic adenocarcinoma from benign mesothelium using a panel of markers.
Area of Science:
- Cytopathology
- Oncology
- Immunohistochemistry
Background:
- Immunocytochemistry (ICC) of serous effusions is crucial for diagnosing benign and malignant cells.
- Accurate differentiation between metastatic adenocarcinoma and benign mesothelium is clinically significant.
Purpose of the Study:
- To develop and evaluate a modified liquid-based cytology (LBC) technique for ICC of serous effusions.
- To assess the efficacy of a specific marker panel in distinguishing metastatic adenocarcinoma from benign mesothelium.
Main Methods:
- A modified LBC technique was applied to 110 serous effusion cases (50 benign, 60 metastatic adenocarcinoma).
- Immunocytochemistry was performed using a panel of markers: EMA, Ber-EP4, Calretinin, and p63.
- Cytological preparations were interpreted by a cytotechnologist and a pathologist, with comparative analysis of results.
Main Results:
- Metastatic adenocarcinoma cases showed 100% positivity for EMA and 91.7% for Ber-EP4, while being negative for Calretinin and p63.
- Benign mesothelium cases were 100% positive for Calretinin and negative for carcinoma markers.
- The diagnostic differentiation based on ICC was statistically significant (p < 0.001).
Conclusions:
- A marker panel including EMA, Ber-EP4, and Calretinin effectively differentiates metastatic adenocarcinoma from benign mesothelium in serous effusions.
- The modified LBC technique provides an effective specimen preparation for ICC analysis in serous effusions.
- This approach improves diagnostic accuracy in the cytopathological evaluation of serous effusions.
Abstract:
Objective: Immunocytochemistry (ICC) of serous effusion is an important tool for the diagnosis of benign and malignant cells. Our aim was to develop a modified liquid-based cytological technique for ICC (i.e., a modified LBC). Methods: Serous effusions of 110 cases were collected for cytological examination: 50 were negative for malignancy albeit benign mesothelium was found, and 60 were confirmed metastatic adenocarcinoma according to the modified LBC preparation. The latter were stained for EMA, Ber-EP4, Calretinin, and p63 then interpreted by both a cytotechnologist and a pathologist. A comparative analysis of the diagnostic results was conducted. Results: The results of the metastatic adenocarcinoma were 100% (60/60) positive for EMA and 91.7% (55/60) positive for Ber-Ep4 but negative for calretinin and p63. Cases negative for malignancy were 100% (50/50) positive for calretinin but negative for carcinoma markers. The difference between ‘positive for metastatic adenocarcinoma’ and ‘negative for malignancy’ in ICC was statistically significant (p < 0.001). Conclusion: The current study demonstrated that a panel marker, comprising EMA, Ber-EP4, and calretinin can be used for differentiating between cases of metastatic adenocarcinoma and benign mesothelium. The serous effusion specimen collected by the modified LBC technique is an effective preparation method for ICC.
