Krishan Awtar, Ganjei-Azar Parvin, Jorda Merce, Hamelik Ronald M, Reis Isildinha M, Nadji Mehrdad
Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida 33101, USA.
Diagn Cytopathol. 2006 Aug;34(8):528-41. doi: 10.1002/dc.20496.
Measurement of electronic volume versus DNA content of nuclei can be used to discriminate between normal and malignant cells. Epithelial membrane antigen immunocytochemistry (EMA-ICC), a helpful ancillary test in body cavity fluids, is not universally accurate for detecting malignancy in effusions. The current study was undertaken to determine if multiparametric flow cytometry (based on simultaneous analysis of light scatter, nuclear volume, DNA, and nuclear protein content) in combination with (EMA-ICC) could be used for the detection of malignant cells in peritoneal and pleural fluids. We studied 130 body cavity fluids (68 peritoneal and 62 pleural fluids) by conventional cytology and multiparametric laser flow cytometry. EMA-ICC was performed using EMA antibodies and L-SAB detection system (DakoCytomation, Carpinteria, CA). EMA-ICC had significantly higher sensitivity than conventional cytology (79% versus 59%, P = 0.016) and ploidy (79% versus 38%, P = 0.001). Cytology had significantly higher specificity than ploidy (97% versus 82%, P = 0.012). The differences in specificity between EMA-ICC and ploidy (87% versus 82%, P= 0.607) or EMA-ICC and cytology (87% versus 97%, P = 0.109) were not statistically significant. However, assuming serial testing, sensitivity increased significantly for the combinations of cytology and EMA-ICC (79.4%, P = 0.016) and cytology and ploidy (73.5%, P = 0.004) as compared to cytology alone (58.8%). Also, the combination of cytology and ploidy had a higher sensitivity than ploidy alone (73% versus 38%, P < 0.0001). However, the sensitivity associated with the three tests used in serial (85.3%) was not significantly different from the sensitivities corresponding to the combination of cytology and EMA-ICC (79%) or cytology and ploidy (73%). Multiparametric flow cytometry utilizing high resolution DNA, nuclear volume, protein measurement, and ICC, in combination with cytomorphology, may be a valuable tool for rapid identification of malignant cells in body cavity fluids.
通过测量细胞核的电子体积与DNA含量可用于区分正常细胞和恶性细胞。上皮膜抗原免疫细胞化学（EMA - ICC）在体腔液检测中是一项有用的辅助检测，但在检测积液中的恶性肿瘤时并不总是准确的。本研究旨在确定多参数流式细胞术（基于光散射、核体积、DNA和核蛋白含量的同步分析）结合EMA - ICC是否可用于检测腹腔和胸腔积液中的恶性细胞。我们通过传统细胞学和多参数激光流式细胞术研究了130份体腔液（68份腹腔积液和62份胸腔积液）。使用EMA抗体和L - SAB检测系统（DakoCytomation，加利福尼亚州卡平特里亚）进行EMA - ICC检测。EMA - ICC的敏感性显著高于传统细胞学（79%对59%，P = 0.016）和倍体分析（79%对38%，P = 0.001）。细胞学的特异性显著高于倍体分析（97%对82%，P = 0.012）。EMA - ICC与倍体分析之间的特异性差异（87%对82%，P = 0.607）或EMA - ICC与细胞学之间的特异性差异（87%对97%，P = 0.109）无统计学意义。然而，假设进行系列检测，与单独的细胞学检测（58.8%）相比，细胞学与EMA - ICC联合检测（79.4%，P = 0.016）以及细胞学与倍体分析联合检测（73.5%，P = 0.004）的敏感性显著增加。此外，细胞学与倍体分析联合检测的敏感性高于单独的倍体分析（73%对38%，P < 0.0001）。然而，系列使用这三种检测方法的敏感性（85.3%）与细胞学和EMA - ICC联合检测（79%）或细胞学和倍体分析联合检测（73%）的敏感性无显著差异。利用高分辨率DNA、核体积、蛋白质测量和免疫细胞化学的多参数流式细胞术，结合细胞形态学，可能是快速识别体腔液中恶性细胞的一种有价值的工具。
