Use of monoclonal antibody panel to identify malignant cells in cerebrospinal fluid.

A panel of monoclonal antibodies was systematically applied to cerebrospinal fluid from 17 patients with suspected neoplastic meningitis and the results were compared with those obtained from routine cytological preparations. The antibody panel consisted of markers for neuroectodermal tissue ( UJ13A ), epithelial cytokeratin ( LE61 ), leucocytes ( 2D1 ), and neoplastic neuroblasts ( UJ181 .4). Additional antibodies were used to refine diagnosis when indicated. Cerebrospinal fluid samples from 12 patients with non-neoplastic conditions were used as controls. The use of monoclonal antibodies gave a positive diagnosis in 16/17 cases and the cells were accurately categorised as carcinoma (5/6 cases), neuroectodermal tumour (8/8 cases), and lymphoma (3/3 cases). In the 14 cases examined by routine cytology, malignant cells were reported in 10 cases and accurately categorised in only 3/14 cases. Immunocytological testing of cerebrospinal fluid with an antibody panel has greatly increased the accuracy with which malignant cells can be identified and categorised.