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. 1989 Nov;42(11):1184–1189. doi: 10.1136/jcp.42.11.1184

Evaluation of impact of immunocytochemical techniques in cytological diagnosis of neoplastic effusions.

A Linari 1, G Bussolati 1
PMCID: PMC501979  PMID: 2685053

Abstract

A prospective study (1984-87) on the immunocytochemical identification of cancer cells in effusions using HMFG2 monoclonal antibody, and in addition, monoclonal anti-CEA and B72.3 antibodies in cases of suspected mesothelioma, was undertaken. On the basis of cytology alone, of a total of 2362 pleural, peritoneal, and pericardial effusions, 525 cases were diagnosed as positive and 1485 as negative for neoplastic cells, while in 352 (15%) specimens from 307 patients the diagnosis was doubtful. Sections of the embedded sediment of doubtful cases were tested with HMFG2 antibody and proved positive in 215 cases, negative in 108, and inconclusive in 29. The results were checked by following the clinical outcome of the cases. The method was specific in identifying cancer cells in cases at best diagnosed as suspicious on the basis of cytology alone; this represents a clear diagnostic gain. Sensitivity of the test, however, was relatively low (41%). Combined cytological and immunocytochemical characteristics (CEA negative and only some of the neoplastic cells positive with HMFG2 and B72.3 monoclonal antibodies) permitted diagnosis on the effusions of most cases of mesothelioma. The impact of the diagnosis on the progress of the disease was not appreciable as no difference in outcome was noted, irrespective of whether cancer cells had been recognised. The occurrence of an effusion remains an ominous sign in most patients treated for cancer.

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Selected References

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  1. Arklie J., Taylor-Papadimitrious J., Bodmer W., Egan M., Millis R. Differentiation antigens expressed by epithelial cells in the lactating breast are also detectable in breast cancers. Int J Cancer. 1981 Jul 15;28(1):23–29. doi: 10.1002/ijc.2910280105. [DOI] [PubMed] [Google Scholar]
  2. Boon M. E., Kwee H. S., Alons C. L., Morawetz F., Veldhuizen R. W. Discrimination between primary pleural and primary peritoneal mesotheliomas by morphometry and analysis of the vacuolization pattern of the exfoliated mesothelial cells. Acta Cytol. 1982 Mar-Apr;26(2):103–108. [PubMed] [Google Scholar]
  3. Bussolati G. A celloidin bag for the histological preparation of cytologic material. J Clin Pathol. 1982 May;35(5):574–576. doi: 10.1136/jcp.35.5.574. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cibas E. S., Corson J. M., Pinkus G. S. The distinction of adenocarcinoma from malignant mesothelioma in cell blocks of effusions: the role of routine mucin histochemistry and immunohistochemical assessment of carcinoembryonic antigen, keratin proteins, epithelial membrane antigen, and milk fat globule-derived antigen. Hum Pathol. 1987 Jan;18(1):67–74. doi: 10.1016/s0046-8177(87)80196-x. [DOI] [PubMed] [Google Scholar]
  5. Delsol G., Gatter K. C., Stein H., Erber W. N., Pulford K. A., Zinne K., Mason D. Y. Human lymphoid cells express epithelial membrane antigen. Implications for diagnosis of human neoplasms. Lancet. 1984 Nov 17;2(8412):1124–1129. doi: 10.1016/s0140-6736(84)91558-7. [DOI] [PubMed] [Google Scholar]
  6. Epenetos A. A., Canti G., Taylor-Papadimitriou J., Curling M., Bodmer W. F. Use of two epithelium-specific monoclonal antibodies for diagnosis of malignancy in serous effusions. Lancet. 1982 Nov 6;2(8306):1004–1006. doi: 10.1016/s0140-6736(82)90047-2. [DOI] [PubMed] [Google Scholar]
  7. Ghosh A. K., Gatter K. C., Dunnill M. S., Mason D. Y. Immunohistological staining of reactive mesothelium, mesothelioma, and lung carcinoma with a panel of monoclonal antibodies. J Clin Pathol. 1987 Jan;40(1):19–25. doi: 10.1136/jcp.40.1.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Ghosh A. K., Mason D. Y., Spriggs A. I. Immunocytochemical staining with monoclonal antibodies in cytologically "negative" serous effusions from patients with malignant disease. J Clin Pathol. 1983 Oct;36(10):1150–1153. doi: 10.1136/jcp.36.10.1150. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Ghosh A. K., Spriggs A. I., Curling M. Tumour markers in serous effusions. Lancet. 1984 Feb 11;1(8372):338–338. doi: 10.1016/s0140-6736(84)90381-7. [DOI] [PubMed] [Google Scholar]
  10. Harkness R. A., Lund R. J. Cerebrospinal fluid concentrations of hypoxanthine, xanthine, uridine and inosine: high concentrations of the ATP metabolite, hypoxanthine, after hypoxia. J Clin Pathol. 1983 Jan;36(1):1–8. doi: 10.1136/jcp.36.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Heyderman E., Neville A. M. A shorter immunoperoxidase technique for the demonstration of carcinoembryonic antigen and other cell products. J Clin Pathol. 1977 Feb;30(2):138–140. doi: 10.1136/jcp.30.2.138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hilborne L. H., Cheng L., Nieberg R. K., Lewin K. J. Evaluation of an antibody to human milk fat globule antigen in the detection of metastatic carcinoma in pleural, pericardial and peritoneal fluids. Acta Cytol. 1986 May-Jun;30(3):245–250. [PubMed] [Google Scholar]
  13. Hsu S. M., Raine L., Fanger H. Use of avidin-biotin-peroxidase complex (ABC) in immunoperoxidase techniques: a comparison between ABC and unlabeled antibody (PAP) procedures. J Histochem Cytochem. 1981 Apr;29(4):577–580. doi: 10.1177/29.4.6166661. [DOI] [PubMed] [Google Scholar]
  14. Johnston W. W. Applications of monoclonal antibodies in clinical cytology as exemplified by studies with monoclonal antibody B72.3. The George N. Papanicolaou award lecture. Acta Cytol. 1987 Sep-Oct;31(5):537–556. [PubMed] [Google Scholar]
  15. Johnston W. W. The malignant pleural effusion. A review of cytopathologic diagnoses of 584 specimens from 472 consecutive patients. Cancer. 1985 Aug 15;56(4):905–909. doi: 10.1002/1097-0142(19850815)56:4<905::aid-cncr2820560435>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  16. Kwee W. S., Veldhuizen R. W., Alons C. A., Morawetz F., Boon M. E. Quantitative and qualitative differences between benign and malignant mesothelial cells in pleural fluid. Acta Cytol. 1982 Jul-Aug;26(4):401–406. [PubMed] [Google Scholar]
  17. Lauritzen A. F. Distinction between cells in serous effusions using a panel of antibodies. Virchows Arch A Pathol Anat Histopathol. 1987;411(3):299–304. doi: 10.1007/BF00735037. [DOI] [PubMed] [Google Scholar]
  18. Mariani-Costantini R., Ménard S., Clemente C., Tagliabue E., Colnaghi M. I., Rilke F. Immunocytochemical identification of breast carcinoma cells in effusions using a monoclonal antibody. J Clin Pathol. 1982 Sep;35(9):1037–1037. doi: 10.1136/jcp.35.9.1037. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Marshall R. J., Herbert A., Braye S. G., Jones D. B. Use of antibodies to carcinoembryonic antigen and human milk fat globule to distinguish carcinoma, mesothelioma, and reactive mesothelium. J Clin Pathol. 1984 Nov;37(11):1215–1221. doi: 10.1136/jcp.37.11.1215. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Martin S. E., Moshiri S., Thor A., Vilasi V., Chu E. W., Schlom J. Identification of adenocarcinoma in cytospin preparations of effusions using monoclonal antibody B72.3. Am J Clin Pathol. 1986 Jul;86(1):10–18. doi: 10.1093/ajcp/86.1.10. [DOI] [PubMed] [Google Scholar]
  21. Ménard S., Rilke F., Della Torre G., Mariani-Costantini R., Regazzoni M., Tagliabue E., Alasio L., Colnaghi M. I. Sensitivity enhancement of the cytologic detection of cancer cells in effusions by monoclonal antibodies. Am J Clin Pathol. 1985 May;83(5):571–576. doi: 10.1093/ajcp/83.5.571. [DOI] [PubMed] [Google Scholar]
  22. Nuti M., Teramoto Y. A., Mariani-Costantini R., Hand P. H., Colcher D., Schlom J. A monoclonal antibody (B72.3) defines patterns of distribution of a novel tumor-associated antigen in human mammary carcinoma cell populations. Int J Cancer. 1982 May 15;29(5):539–545. doi: 10.1002/ijc.2910290509. [DOI] [PubMed] [Google Scholar]
  23. Permanetter W., Wiesinger H. Immunohistochemical study of lysozyme, alpha 1-anti-chymotrypsin, tissue polypeptide antigen, keratin and carcinoembryonic antigen in effusion sediments. Acta Cytol. 1987 Mar-Apr;31(2):104–112. [PubMed] [Google Scholar]
  24. Szpak C. A., Johnston W. W., Lottich S. C., Kufe D., Thor A., Schlom J. Patterns of reactivity of four novel monoclonal antibodies (B72.3, DF3, B1.1 and B6.2) with cells in human malignant and benign effusions. Acta Cytol. 1984 Jul-Aug;28(4):356–367. [PubMed] [Google Scholar]
  25. Szpak C. A., Johnston W. W., Roggli V., Kolbeck J., Lottich S. C., Vollmer R., Thor A., Schlom J. The diagnostic distinction between malignant mesothelioma of the pleura and adenocarcinoma of the lung as defined by a monoclonal antibody (B72.3). Am J Pathol. 1986 Feb;122(2):252–260. [PMC free article] [PubMed] [Google Scholar]
  26. Taylor-Papadimitriou J., Peterson J. A., Arklie J., Burchell J., Ceriani R. L., Bodmer W. F. Monoclonal antibodies to epithelium-specific components of the human milk fat globule membrane: production and reaction with cells in culture. Int J Cancer. 1981 Jul 15;28(1):17–21. doi: 10.1002/ijc.2910280104. [DOI] [PubMed] [Google Scholar]
  27. To A., Coleman D. V., Dearnaley D. P., Ormerod M. G., Steele K., Neville A. M. Use of antisera to epithelial membrane antigen for the cytodiagnosis of malignancy in serous effusions. J Clin Pathol. 1981 Dec;34(12):1326–1332. doi: 10.1136/jcp.34.12.1326. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Whitaker D., Shilkin K. B. Diagnosis of pleural malignant mesothelioma in life--a practical approach. J Pathol. 1984 Jul;143(3):147–175. doi: 10.1002/path.1711430303. [DOI] [PubMed] [Google Scholar]

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