title: Immunocytochemical utility of claudin-4 versus those of Ber-EP4 and MOC-31 in effusion cytology.
abstract: BACKGROUND
  Recently, claudin-4 (CL4) immunocytochemistry was reported to be useful for differential diagnosis in effusion cytology. We wondered whether CL4 might be useful for "single-shot" identification of metastatic carcinoma. The purpose of this study was to evaluate the usefulness of CL4 in effusion cytology.
  
  
  METHODS
  In total, 266 cases (169 metastatic carcinomas, eight malignant mesotheliomas, and 89 reactive mesothelial cells) were selected. Immunocytochemical examinations of cell-block sections were performed for CL4, Ber-EP4, and MOC-31. We used an arbitrary 4-tiered scale based on both staining intensity and positive-cell percentage among all target cells, and calculated a staining index score (sum of the above two scores).
  
  
  RESULTS
  In a ROC-curve analysis, higher area-under-curve values were found for CL4 than for Ber-EP4 or MOC-31 (0.982, 0.942, and 0.926, respectively).
  
  
  CONCLUSIONS
  Since CL4 exhibited similar or superior usefulness to Ber-EP4 and MOC-31, it could become the first choice for the above differential diagnosis in effusion cytology. Diagn. Cytopathol. 2016;44:499-504. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Oda
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa.
authors.forename: Sho
authors.initials: S
authors.lastname: Ogata
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa.
authors.forename: Saki
authors.initials: S
authors.lastname: Kawaguchi
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa.
authors.forename: Shinya
authors.initials: S
authors.lastname: Minabe
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa.
authors.forename: Misaki
authors.initials: M
authors.lastname: Dokyu
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kumazawa
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimazaki
authors.affiliation: Department of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Takano
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ozeki
authors.affiliation: Department of Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kanoh
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa.|Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Nakanishi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000276:immunology*; D001202:Ascitic Fluid / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000276:immunology; D002277:Carcinoma / Q000473:pathology*; D062506:Claudin-4 / Q000276:immunology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008654:Mesothelioma / Q000473:pathology*; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000473:pathology*
chemical_list: D000911:Antibodies, Monoclonal; C117805:Ber-EP4 monoclonal antibody; D014408:Biomarkers, Tumor; D062506:Claudin-4; C546130:MOC-31 monoclonal antibody, human
keywords: Ber-EP4; MOC-31; claudin-4; effusion cytology; immunocytochemistry