Zhang X, Chen L, Liu Y, Xu Y, Zhang X, Shi Y, Wang C, Zhang P L, Liu Y
Department of Cytology, Tianjin Medical University Clinical Hospital of Gynecology Obstetrics, Tianjin, China.
Department of Pathology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China.
Cytopathology. 2018 Jun;29(3):247-253. doi: 10.1111/cyt.12514. Epub 2017 Dec 27.
Precise cytological diagnosis of pelvic high-grade serous carcinoma (HGSC) in ascites is important for tumour staging, therapeutic decision-making and prognostic evaluation. However, it can often be difficult to distinguish metastatic HGSC cells from reactive mesothelial cells based on morphology alone. Immunocytochemical analysis of ascites cell blocks has been used to obtain accurate diagnosis and provide a reliable basis for treatment decisions in the clinic. This study was performed to determine whether a panel of antibodies is necessary to achieve high specificity and sensitivity for the identification of HGSC cells.
Ascites samples from 70 cases (70/253, 27.7%) of histologically confirmed HGSC were postoperatively collected from 2012 to 2015 and were immunocytochemically analysed.
The sensitivity and specificity of Ber-EP4 (a marker of HGSC) for detecting HGSC was 85.7% and 82.1%, respectively, whereas the sensitivity and specificity of HBME-1 for identifying mesothelial cells was 100% and 68.3%, respectively. To improve the rate of detection further of HGSC, 29 cases of ascites were also stained for E-cadherin (a marker of HGSC) and calretinin (a marker of mesothelial cells). The combination of Ber-EP4 and E-cadherin as markers of adenocarcinoma cells increased the sensitivity and specificity for HGSC detection to 100% and 88.9%, respectively. Meanwhile, the sensitivity and specificity for mesothelial cell identification increased to 100% and 90%, respectively, when HBME-1 and calretinin were combined.
This panel of complementary biomarkers is valuable and ideal for the differential diagnosis of HGSC based on ascites cytology.
腹水中盆腔高级别浆液性癌（HGSC）的精确细胞学诊断对于肿瘤分期、治疗决策和预后评估至关重要。然而，仅基于形态学往往难以将转移性HGSC细胞与反应性间皮细胞区分开来。腹水细胞块的免疫细胞化学分析已用于获得准确诊断，并为临床治疗决策提供可靠依据。本研究旨在确定一组抗体对于识别HGSC细胞是否有必要以实现高特异性和敏感性。
2012年至2015年术后收集70例组织学确诊的HGSC患者的腹水样本（70/253，27.7%），并进行免疫细胞化学分析。
Ber-EP4（HGSC的一种标志物）检测HGSC的敏感性和特异性分别为85.7%和82.1%，而HBME-1识别间皮细胞的敏感性和特异性分别为100%和68.3%。为进一步提高HGSC的检测率，还对29例腹水样本进行了E-钙黏蛋白（HGSC的一种标志物）和钙视网膜蛋白（间皮细胞的一种标志物）染色。将Ber-EP4和E-钙黏蛋白作为腺癌细胞标志物联合使用时，HGSC检测的敏感性和特异性分别提高到100%和88.9%。同时，当HBME-1和钙视网膜蛋白联合使用时，间皮细胞识别的敏感性和特异性分别提高到100%和90%。
这组互补的生物标志物对于基于腹水细胞学的HGSC鉴别诊断具有重要价值且非常理想。
