Identification of the primary site of metastatic adenocarcinoma in serous effusions. Value of an immunocytochemical panel added to the clinical arsenal.
OBJECTIVE
To use an immunocytochemical panel as ancillary method to identify the origin of adenocarcinomas in serous effusions.


METHODS
Serous effusion samples examined cytologically in the Department of Surgical Pathology, A. C. Camargo Hospital, between 1966 and 1990, were investigated. Of 4,297 cases, 2,317 were associated with adenocarcinoma, and 1,099 were positive for adenocarcinoma by cytologic examination. We selected a total of 248 cases of different origins to subject to immunoreactions. A panel composed of CA-125, CA-19.9, HBME-1, lactoferrin and BRST 2 was tested for the efficiency of these antibodies under two conditions: the panel alone and associated with clinical data, such as anatomic localization of the effusion (pleural or ascitic) and patient sex and age.


RESULTS
BRST 2 and lactoferrin were both positive in 29.9% of cases of adenocarcinoma of breast origin; CA-125 and HBME-1 were 28.6% and 25.0% positive in cases of adenocarcinoma of the ovaries, respectively. These immunoreactivities were highly specific when compared to the others. The statistical significance of the results was improved by information on the anatomic location of the effusions and patient sex.


CONCLUSIONS
Our data strongly indicate that BRST 2 and lactoferrin are important components of an immunocytochemical panel used to identify carcinomas of breast origin. Similarly, CA-125 and HBME-1 may be useful in suggesting the ovaries as possible primary sites.
Longatto Filho
Adhemar
A
Pathology Division, Alfredo Lutz Institute. longatto16@hotmail.com
Alves
Venâncio Avancini Ferreira
VA
Kanamura
Cristina Takami
CT
Nonogaki
Suely
S
Bortolan
Jeni
J
Lombardo
Valeria
V
Bisi
Helio
H
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D001053:Apolipoproteins; D053399:Apolipoproteins D; D001202:Ascitic Fluid / Q000276:immunology / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D002352:Carrier Proteins / Q000276:immunology; D005260:Female; D006023:Glycoproteins; D006801:Humans; D007150:Immunohistochemistry; D007781:Lactoferrin / Q000276:immunology; D008297:Male; D026901:Membrane Transport Proteins; D009362:Neoplasm Metastasis / Q000473:pathology; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D016066:Pleural Effusion, Malignant / Q000276:immunology / Q000473:pathology*
C024328:APOD protein, human; D001053:Apolipoproteins; D053399:Apolipoproteins D; D002352:Carrier Proteins; D006023:Glycoproteins; D026901:Membrane Transport Proteins; D007781:Lactoferrin