title: Immunohistochemical study of lysozyme, alpha 1-anti-chymotrypsin, tissue polypeptide antigen, keratin and carcinoembryonic antigen in effusion sediments.
abstract: The cellular sediments of 42 malignant and 16 benign effusions (58 cases) were studied using the immunoperoxidase technique. Serial sections of formalin-fixed, paraffin-embedded residual sediments of effusions, sent for routine cytologic examination, were studied by commercially available polyclonal antisera against lysozyme, alpha 1-anti-trypsin, alpha 1-anti-chymotrypsin, tissue polypeptide antigen (TPA), a wide-spectrum anti-keratin, carcinoembryonic antigen (CEA) and, in single cases, thyroglobulin and prostate-specific antigen. A final definite diagnosis from histologic study of biopsy or autopsy specimens was known in all cases. All carcinomas, the mesotheliomas and the reactive mesothelial cells showed a positive reaction for TPA and, partly, the wide-spectrum keratin. Lysozyme could be demonstrated in the cells of the one proven malignant fibrous histiocytoma; all malignant epithelial cells were negative. Alpha 1-anti-chymotrypsin and alpha 1-anti-trypsin showed similar reactions: they were often positive in carcinoma cells of the breast, the bronchial system and the pancreas, in contrast to a mostly negative reaction in carcinomas of the stomach and ovary. CEA showed considerable differences; it was always negative in benign and malignant mesothelial proliferations but mostly positive in carcinomas of the stomach, pancreas and bronchial system. It was only positive in less than 20% of the carcinomas of the breast and always negative in the proven malignant effusions of primary carcinomas of the ovary and prostate. Studying a combination of several tumor markers is possible in serial paraffin-embedded sections and may be a valuable criterion in the cytologic diagnosis of effusions.
mesh_terms: D002272:Carcinoembryonic Antigen / Q000032:analysis; D003581:Cytodiagnosis; D005122:Exudates and Transudates / Q000032:analysis*; D006098:Granulocytes / Q000032:analysis; D006651:Histocytochemistry; D006801:Humans; D007124:Immunoenzyme Techniques; D007633:Keratins / Q000032:analysis; D008264:Macrophages / Q000032:analysis; D009113:Muramidase / Q000032:analysis; D009369:Neoplasms / Q000032:analysis* / Q000473:pathology; D010455:Peptides / Q000032:analysis; D012189:Retrospective Studies; D019396:Tissue Polypeptide Antigen; D000514:alpha 1-Antichymotrypsin / Q000032:analysis
chemical_list: D002272:Carcinoembryonic Antigen; D010455:Peptides; D019396:Tissue Polypeptide Antigen; D000514:alpha 1-Antichymotrypsin; D007633:Keratins; D009113:Muramidase