流式细胞术在肿瘤性渗出液中循环肿瘤细胞检测中的应用。

Flow cytometry in the detection of circulating tumor cells in neoplastic effusions.

机构信息

Department of Obstetrics, Gynaecology and Oncology, Chair of Pathomorphology and Clinical Placentology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland; Department of Tumor Pathology and Pathomorphology, Oncology Centre - Prof. Franciszek Łukaszczyk Memorial Hospital in Bydgoszcz, Poland.

Department of Tumor Pathology and Pathomorphology, Oncology Centre - Prof. Franciszek Łukaszczyk Memorial Hospital in Bydgoszcz, Poland.

出版信息

Clin Chim Acta. 2024 Jan 1;552:117651. doi: 10.1016/j.cca.2023.117651. Epub 2023 Nov 17.

DOI:10.1016/j.cca.2023.117651

PMID:37980974

Abstract

PURPOSE

Despite its limitations, the cytology of body fluids is widely used in diagnosing neoplastic cells. Flow cytometry detects and identifies individual cells, enabling the detection of circulating tumor cells and facilitating diagnosis. This study compared the diagnostic utility of flow cytometry and cytology for detecting cancer cells in peritoneal and pleural fluids.

METHODOLOGY

We used flow cytometry and cytology to examine 119 pleural and peritoneal effusions received for routine screening. Antibodies against clusters of differentiation 45 (CD45), 14 (CD14), and Epithelial cell adhesion molecule (EpCAM) were used to detect malignant cells. Based on combined clinical and diagnostic information, 37 fluid specimens were malignant, and 77 were benign.

RESULTS

Flow cytometry correctly identified 34 cancers, while cytology identified 26 cancers (sensitivity 91.89 % vs. 70.27, respectively). Both methods had equal specificity (98.7 %). At a cut-off of > 0.29 % EpCAM(+) cells to all cells in the samples, flow cytometry accurately detected cancer cells, achieving 89.2 % sensitivity, 90.9 % specificity, and an AUC of 0.959 (p < 0.001).

CONCLUSION

Flow cytometry improves the detection of epithelial cancer cells in peritoneal and pleural fluids compared to conventional cytology. Due to similar specificity and higher sensitivity, flow cytometry offers a promising alternative to cytology for patient screening.

摘要

目的

尽管存在局限性，但体液细胞学在诊断肿瘤细胞方面仍被广泛应用。流式细胞术可用于检测和识别单个细胞，从而实现循环肿瘤细胞的检测并有助于诊断。本研究比较了流式细胞术和细胞学在检测腹腔和胸腔积液中癌细胞的诊断效用。

方法

我们使用流式细胞术和细胞学检查了 119 例常规筛选的胸腔和腹腔积液。采用针对分化簇 45（CD45）、14（CD14）和上皮细胞黏附分子（EpCAM）的抗体来检测恶性细胞。根据联合临床和诊断信息，37 例标本为恶性，77 例为良性。

结果

流式细胞术正确识别出 34 例癌症，而细胞学仅识别出 26 例癌症（敏感性分别为 91.89%和 70.27%）。两种方法的特异性相同（98.7%）。在截断值>0.29% EpCAM(+)细胞占样本中所有细胞的情况下，流式细胞术可准确检测到癌细胞，敏感性为 89.2%，特异性为 90.9%，AUC 为 0.959（p<0.001）。