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6th ESACP Congress, Heidelberg, April 7-11, 1999 |
A107
Aims: To compare 1. the diagnostic usefulness of DNA-flow- (FCM) and
-image-cytometry (ICM) for the identification of malignant cells in effusions
and 2. sensitivities of different algorithms to identify DNA-aneuploidy.
Material and Methods: 200 effusions of which 80 contained cytologically
unequivocal tumor cells (74 carcinoses, 6 mesothelio- mas), 46 with equivocal
cytological diagnoses suspicious for tumor cells, and 74 without tumor cells. Clinical
follow-up was available for all patients. Effusions were formalin fixed, protease
disaggregated DAPI stained for FCM and performed with a PAS cytometer (PARTEC,
Münster, Germany). Image-cytometry was performed on air-dried smears after Feulgen
staining with the AutoCyte QUIC DNA workstation (AutoCyte, Burlington, USA).
Results: The application of three different algorithms each in FCM and ICM
increased the rate of aneuploidy detection in both procedures. DNA-aneuploidy
was detected in 58.8 % of tumor cell positive effusions by FCM and in 87.5 %
by ICM (prevalence), but never in tumor cell negative samples or in effusions
without malignant tumors in the follow-up. 19.6 % of equivocal effusions in
FCM and 45.7 % in ICM revealed DNA-aneuploidy. The positive predictive value
of DNA-aneuploidy for tumor cells in cytologically equivocal effusions was
100.0 % for both FCM and ICM. The negative values were 48.6 % and 72.0 %
respectively. Whereas FCM could differentiate peaks differing only 4 % in DNA
content ICM could identify single nuclei with abnormally high DNA-values
(9c EE).
Discussion: The lower detection rate of DNA-aneuploidy of FCM compared with
ICM was due to frequent prevalence of lymphocytes and granulocytes over
mesothelial- and tumor cells. This disadvantage can be overcome by
differential centrifugation or immunocytochemical gating in multiparameter
flow-cytometry.
COMPARISON OF DIAGNOSTIC EFFICIENCY OF DNA-FLOW- AND -IMAGE- CYTOMETRY IN 200
EFFUSIONS OF TEN SEROUS CAVITIES
Motherby H, Kube M, Pomjanski N, Boros A, Knops K, Böcking A
Institute of Cytopathology, Heinrich-Heine-University Düsseldorf,
Germany