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6th ESACP Congress, Heidelberg, April 7-11, 1999 |
A037
Aims: To find out sensitivity and specificity of AgNOR-staining
and of different modes of dot-counting in mesothelial and/or abnormal cells
in effusions of the serous membranes for identification of tumor cells.
Material and Methods: 20 effusions with carcinoses, 20 with malignant
mesotheliomas, and 20 without tumor cells in the clinical follow-up were
investigated. 20 effusions had tumor cell negative, 30 positive, and
10 equivocal cytological diagnoses. AgNOR-dots were counted subjectively
in 100 mesothelial or abnormal cells per case, 1. all but those in clusters
as one dot, 2. as satellites, 3. number of clusters.
Results: AgNOR-counts as satellites ranged from 1.17-2.33 in reactive
mesothelial cells, from 2.73-10.08 in mesotheliomas and 4.79-11.23 in
carcinoses. Counts of all AgNOR-dots, those in clusters counted as one
ranged from 2.50-4.37 in reactive cells, from 4.68-11.18 in mesotheliomas
and 5.90-12.12 in carcinoses. Mean numbers of clusters per nucleus ranged
from 1.0-2.15 in reactive cells, from 0.44-1.50 in mesotheliomas and from
0.80-1.59 in carcinoses. Using a threshold of 2.5 AgNOR-dots as satellites
100 % sensitivity and specificity was achieved for the differentiation
of reactive mesothelial and mesothelioma cells as well as of carcinoma
cells in effusions. In all (n=10) cytologically doubtful cases (all
mesotheliomas) diagnoses could be decided correctly as to the occurrence
of tumor cells in the clinical follow-up.
Discussion: Counting the number of AgNOR-dots occurring as satellites in
nuclei of mesothelial or diagnostically doubtful atypical cells seems to
be superior to counting all AgNORs per nucleus or per cluster. Applying
the experimentally found threshold of 2.50 AgNORs as satellites in 100
nuclei results in a 100 % correct rate of tumor cell identification including
malignant mesothelioma cells without false positive diagnoses so far. These
results are especially encouraging concerning a sensitive early cytological
diagnosis of malignant mesothelioma in effusions.
AGNOR-QUANTIFICATION FOR IDENTIFICATION OF TUMOR CELLS IN EFFUSIONS OF
THE SEROUS MEMBRANES
Böcking A, Buckstegge B, Murach BL, Motherby H, Pomjanski N
Inst.Cytopathology, Heinrich-Heine-Uiversity, Düsseldorf, Germany