title: A simplified flow cytometric immunophenotyping procedure for the diagnosis of effusions caused by epithelial malignancies.
abstract: Epithelial malignancies frequently metastasize to the serous cavities and result in symptomatic effusions. Cytology has high specificity but moderate sensitivity for the diagnosis of a malignant effusion. We developed and validated a simple, rapid, 3-color flow cytometric panel using the adhesion molecule Ber-EP4 to detect epithelial cells in effusions. One hundred ninety-five consecutive benign and malignant effusions received for routine cytologic examination were analyzed. Eighty-three fluid specimens were benign and 76 were malignant as judged by follow-up data. Ber-EP4-positive cells were detected with flow cytometry in 89.3% of malignant effusions. The sensitivity and specificity of flow cytometry was 88.15% and 97.64% compared with 73.68% and 100% on cytologic examination alone for the presence of a malignant effusion. Flow cytometry is a useful adjunct to cytology for the diagnosis of a malignant effusion and is particularly useful if the cytologic diagnosis is atypical/suspicious or if the cytologic preparations are hypocellular or hemorrhagic.
authors.affiliation: Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Vinodh
authors.initials: V
authors.lastname: Pillai
authors.forename: Edmund S
authors.initials: ES
authors.lastname: Cibas
authors.forename: David M
authors.initials: DM
authors.lastname: Dorfman
mesh_terms: D001202:Ascitic Fluid / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000378:metabolism; D002277:Carcinoma / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism / Q000556:secondary; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping / Q000379:methods*; D009369:Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor