[Significance of combining detection of E-cadherin, carcinoembryonic antigen, and calretinin in cytological differential diagnosis of serous effusion].

BACKGROUND & OBJECTIVE: The morphological characteristics of metastatic adenocarcinoma cells,malignant mesothelioma cells,and reactive mesothelial cells in serous effusions are similar. Sometimes, it is difficult to make a correct diagnosis just based on the cytological characteristics. Although now immunocytochemistry has been widely used in this field,yet only a few antibodies were reported in China,which can't help to make a correct differential diagnosis. This study was to evaluate the value of combining detection of E-cadherin,carcinoembryonic antigen (CEA),and calretinin in cytological differential diagnosis of serous effusion. METHODS: A total of 93 effusion cytology specimens (66 pleural fluid samples, 24 ascites samples, 3 pericardial fluid samples)from 55 cases of metastatic adenocarcinoma, 6 cases of malignant mesothelioma, and 32 cases of reactive mesothelium were collected. All cases were confirmed histologically or clinically. Materials from each case were prepared in HE staining smears,and cell blocks,immunocytochemical staining was performed on cell block sections. RESULTS: In diagnosing metastatic adenocarcinoma, the sensitivities of E-cadherin, and CEA were 85.5%(47/55), and 79.6% (43/55), the specificities were 100% (38/38), and 97.4% (37/38);if E-cadherin and CEA were used together,the positive rate was 96.4%(53/55). The sensitivity of calretinin for mesothelial cells was 81.6%(31/38),and the specificity was 87.2% (48/55). CONCLUSION: The combination of E-cadherin, CEA, and calretinin is a very useful antibody panel in cytological differential diagnosis for metastatic adenocarcinoma and mesothelial cells in serous effusion.