title: Significance of cell proliferation markers (Minichromosome maintenance protein 7, topoisomerase IIalpha and Ki-67) in cavital fluid cytology: can we differentiate reactive mesothelial cells from malignant cells?
abstract: The aim of this study was to evaluate whether immunocytochemical expressions of proliferation markers, such as minichromosome maintenance protein 7 (MCM 7), topoisomerase IIalpha (topo IIalpha), and Ki-67, in reactive mesothelial cells and malignant cells obtained from cavital fluids could be useful for their differential diagnosis. Samples diagnosed as reactive mesothelial cells (14 cases) or malignant tumors (28 cases) in cavital fluids were examined. Immunocytochemical staining of MCM 7, topo IIalpha, and Ki-67 was performed with the universal immunoperoxidase polymer method. In reactive mesothelial cells, MCM 7 was stained in a fine granular pattern and its distribution was uniform in the nuclei. Topo IIalpha and Ki-67 were stained in a coarse granular pattern and the distributions were the same as MCM 7. In contrast, in malignant cells, MCM 7 was stained in an irregular and fine granular pattern, and topo IIalpha and Ki-67 were stained in a uniform and coarse granular pattern. Labeling indices of MCM 7 (cut-off value; 30%, sensitivity; 100%, and specificity; 100%), topo IIalpha (cut-off value; 15%, sensitivity; 89.3%, and specificity; 92.9%) and Ki-67 (cut-off value; 30%, sensitivity; 64.3%, and specificity; 92.9%) of malignant cells were significantly higher than those of reactive mesothelial cells. MCM 7, topo IIalpha, and Ki-67 are different types of cell proliferation markers. MCM 7 and topo IIalpha, in particular, could be reliable tools for differential diagnosis between reactive mesothelial cells and malignant cells.
authors.affiliation: Division of Diagnostic Pathology and Cytology, Higashiyamato Hospital, Tokyo, Japan. k1100rs@yamatokai.or.jp
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Kimura
authors.forename: Jumpei
authors.initials: J
authors.lastname: Kawamura
authors.forename: Jun
authors.initials: J
authors.lastname: Watanabe
authors.forename: Shingo
authors.initials: S
authors.lastname: Kamoshida
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawai
authors.forename: Isao
authors.initials: I
authors.lastname: Okayasu
authors.forename: Sadahito
authors.initials: S
authors.lastname: Kuwao
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology; D000368:Aged; D000951:Antigens, Neoplasm / Q000378:metabolism*; D001202:Ascitic Fluid / Q000378:metabolism / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology; D018797:Cell Cycle Proteins / Q000378:metabolism*; D049109:Cell Proliferation; D004250:DNA Topoisomerases, Type II / Q000378:metabolism*; D004268:DNA-Binding Proteins / Q000378:metabolism*; D004848:Epithelium / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008654:Mesothelioma / Q000378:metabolism / Q000473:pathology; D064168:Minichromosome Maintenance Complex Component 7; D009687:Nuclear Proteins / Q000378:metabolism*; D010534:Peritoneal Neoplasms / Q000378:metabolism / Q000473:pathology; D010997:Pleural Neoplasms / Q000378:metabolism / Q000473:pathology; D055752:Small Cell Lung Carcinoma / Q000378:metabolism / Q000473:pathology; D035423:Thoracic Cavity / Q000378:metabolism / Q000473:pathology*
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D018797:Cell Cycle Proteins; D004268:DNA-Binding Proteins; D019394:Ki-67 Antigen; D009687:Nuclear Proteins; C101624:MCM7 protein, human; D064168:Minichromosome Maintenance Complex Component 7; D004250:DNA Topoisomerases, Type II