Detection of tumor cells in body cavity fluids by flow cytometric and immunocytochemical analysis

Awtar Krishan, Parvin Ganjei-Azar, Merce Jorda, Ronald M. Hamelik, Isildinha Reis, Mehrdad Nadji

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

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 = 0.076; 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.

Original languageEnglish
Pages (from-to)528-541
Number of pages14
JournalDiagnostic Cytopathology
Volume34
Issue number8
DOIs
StatePublished - Aug 1 2006

Fingerprint

Body Fluids
Mucin-1
Cell Biology
Ploidies
Immunohistochemistry
Neoplasms
Flow Cytometry
Nuclear Proteins
DNA
Cell Body
Ascitic Fluid
Lasers
Light
Antibodies

Keywords

  • Ascites
  • Flow cytometry
  • Immunocytochemistry
  • Pleural fluids

ASJC Scopus subject areas

  • Anatomy

Cite this

Detection of tumor cells in body cavity fluids by flow cytometric and immunocytochemical analysis. / Krishan, Awtar; Ganjei-Azar, Parvin; Jorda, Merce; Hamelik, Ronald M.; Reis, Isildinha; Nadji, Mehrdad.

In: Diagnostic Cytopathology, Vol. 34, No. 8, 01.08.2006, p. 528-541.

Research output: Contribution to journalArticle

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