DNA Ploidy Analysis and Cell Block Immunohistochemistry in the Diagnosis of Malignant Effusions

Puri, Megha; Sen, Rajeev; Gupta, Monika; Kalra, Rajnish; Bhargava, Shilpi; Puri, Karan

doi:10.1159/000501790

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…The reasons are considered to include diploid tumors or the presence of chromosome replication and chromosome deletion in some tumors, which lead to the masking of abnormal DNA results, which indicated that the ECS + CB analyses gave false negative results and confirmed the accuracy of the cellular DNA–ICM results. There was no statistical difference between the three methods, similar to the results found by Puri 29 …”

Section: Discussionsupporting

confidence: 88%

DNA image cytometry ploidy analysis technique improves the detection rate of pleural effusion cytology

Gai

et al. 2022

Diagnostic Cytopathology

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Objective To explore the clinical diagnostic value of DNA image cytometry (DNA–ICM) ploidy analysis in malignant pleural effusion cancer screening, this study analyzed the effect of exfoliated cell smears (ECSs), cell blocks (CBs), and immunochemistry. Method A total of 830 cases of pleural effusion were considered for the DNA–ICM ploidy analysis. The ECSs were centrifuged, the CBs were formed, and the DNA–ICM ploidy analysis was carried out in the diagnosis of malignant pleural effusion. Immunochemistry and biopsy was applied to differentiate between benign and malignant pleural effusion and to determine the source of the latter. The sensitivity and specificity differences between the three methods alone and in combination were compared. Results The sensitivity of the DNA–ICM, ECS, and CB methods was 96.28%, 94.93%, and 95.95%, respectively, and the specificity of each method was 86.52%, 87.08%, and 86.14%, respectively. The sensitivity and specificity of the combined diagnosis method were 99.32% and 75.09%, respectively. Among the 22 cases diagnosed as positive in the DNA–ICM ploidy analysis but negative in the ECS and CB analyses, four cases were diagnosed as positive by comprehensive clinical diagnosis. Conclusion The sensitivity and specificity of DNA–ICM ploidy analysis are high; the positive detection rate of pleural fluid cytology is effectively increased, and the missed detection rate of cell pathologies is effectively reduced. The combination of the three methods significantly improves the specificity and sensitivity of the diagnosis of malignant pleural effusion, and immunochemistry with CBs can be used to accurately analyze the primary tumor site.

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Section: Discussionsupporting

confidence: 88%

DNA image cytometry ploidy analysis technique improves the detection rate of pleural effusion cytology

Gai

et al. 2022

Diagnostic Cytopathology

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“…ICC has been shown to have superior staining results in cell blocks compared to conventional smears and LBC specimens. 9,[13][14][15] In this study, we prepared cell blocks from cells pretreated with an LBC fixative solution and cell blocks from LBC residual specimens. Our preliminary experiments showed that the immunostaining of cells treated with LBC fixative was lower than that of cells fixed with 10% NBF.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, morphological approaches are limited, and ICC, FISH, and nucleic acid sequence analyses using DNA and RNA extraction are useful. ICC has been shown to have superior staining results in cell blocks compared to conventional smears and LBC specimens 9,13–15 . In this study, we prepared cell blocks from cells pretreated with an LBC fixative solution and cell blocks from LBC residual specimens.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of DNA/RNA quality from cell block of malignant mesothelioma and lung adenocarcinoma

Tatsumi

Takeuchi

Fujii

et al. 2022

Diagnostic Cytopathology

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Malignant mesothelioma (MM) is a rare and highly lethal tumor that arises from mesothelial tissue on the surface of the chest and abdominal cavity. Cytological examination of body fluids, including pleural fluid and ascites, is essential for the differentiation of malignant mesothelioma from other carcinomas, such as lung and gastrointestinal carcinomas and metastatic tumors. To evaluate the effectiveness of cell block preparation procedures, which are used for immunocytochemical staining and genetic panel analysis of tumor-specific gene mutations, we used various fixatives. We also evaluated the effects of immunostaining, and the quality of nucleic acids for genetic analysis.Methods: Cell blocks were prepared using the malignant mesothelioma cell lines MESO4 and H226 and non-small cell lung carcinoma cell line HCC78. The cells were fixed using 10% neutral buffered formalin and four different fixatives for liquid cytology. Fixed cells were formed into cell clusters using sodium alginate or centrifugation, and paraffin-embedded cell blocks were prepared.Results: Cell blocks were morphologically evaluated by hematoxylin and eosin and immunocytological staining, and the nucleic acid quality was evaluated by DNA/RNA extraction, qPCR, and next-generation sequence analysis. D2-40 and WT1 staining differed depending on the fixation solution and the cell cluster formation method; however, the degree of nucleic acid degradation was not impaired by any method. Conclusion:Although the morphological evaluation of cytology specimens is affected by the method of cell block preparation, it is still useful for nucleic acid extraction and gene panel analysis, as long as there are sufficient amounts of tumor cells.

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“…Moreover, it is difficult to diagnose some atypical cells only with cytological specimens. With the help of some auxiliary tools, this gray area can be reduced, which is helpful to achieve a clear diagnosis ( 7 ). Previous studies have shown that some laboratory indicators, such as various tumor markers, vascular endothelial growth factor, and serum BNP ( 8 – 10 ), have certain value in the differential diagnosis of benign and malignant PE.…”

Section: Introductionmentioning

confidence: 99%

Development and validation a simple scoring system to identify malignant pericardial effusion

Jin

Fang

et al. 2022

Front. Oncol.

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BackgroundMalignant pericardial effusion (MPE) is a serious complication in patients with advanced malignant tumors, which indicates a poor prognosis. However, its clinical manifestations lack specificity, making it challenging to distinguish MPE from benign pericardial effusion (BPE). The aim of this study was to develop and validate a scoring system based on a nomogram to discriminate MPE from BPE through easy-to-obtain clinical parameters.MethodsIn this study, the patients with pericardial effusion who underwent diagnostic pericardiocentesis in Taizhou Hospital of Zhejiang Province from February 2013 to December 2021 were retrospectively analyzed. The eligible patients were divided into a training group (n = 161) and a validation group (n = 66) according to the admission time. The nomogram model was established using the meaningful indicators screened by the least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression. Then, a new scoring system was constructed based on this nomogram model.ResultsThe new scoring system included loss of weight (3 points), no fever (4 points), mediastinal lymph node enlargement (2 points), pleural effusion (6 points), effusion adenosine deaminase (ADA≦18U/L) (5 points), effusion lactate dehydrogenase (LDH>1033U/L) (7 points), and effusion carcinoembryonic antigen (CEA>4.9g/mL) (10 points). With the optimal cut-off value was 16 points, the area under the curve (AUC), specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) for identifying MPE were 0.974, 95.1%, 91.0%, 85.6%, 96.8%, 10.56 and 0.05, respectively, in the training set and 0.950, 83.3%, 95.2%, 90.9%, 90.9%, 17.50, and 0.18, respectively, in the validation set. The scoring system also showed good diagnostic accuracy in differentiating MPE caused by lung cancer from tuberculous pericardial effusion (TPE) and MPE including atypical cell from BPE.ConclusionThe new scoring system based on seven easily available variables has good diagnostic value in distinguishing MPE from BPE.

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DNA Ploidy Analysis and Cell Block Immunohistochemistry in the Diagnosis of Malignant Effusions

Cited by 5 publications

References 13 publications

DNA image cytometry ploidy analysis technique improves the detection rate of pleural effusion cytology

DNA image cytometry ploidy analysis technique improves the detection rate of pleural effusion cytology

Evaluation of DNA/RNA quality from cell block of malignant mesothelioma and lung adenocarcinoma

Development and validation a simple scoring system to identify malignant pericardial effusion

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