A panel of markers for identification of malignant and non-malignant cells in culture from effusions

Our plain-English summary of A panel of markers for identification of malignant and non-malignant cells in culture from effusions, by F.P. Carneiro, M.I. Muniz-Junqueira, F. Pittella-Silva, et al (Oncology Reports, 2017).

The study

• Authors: F.P. Carneiro, M.I. Muniz-Junqueira, F. Pittella-Silva, M.V. Carneiro, G.H.S. Takano, L.M.S. Vianna, L.B. De Andrade, T.M.M.L. De Castro, I. Peres, T.K. Dos Santos Borges, V.M. Ferreira, A.B. Motoyama
• Journal: Oncology Reports
• Published: 2017;38(6):3538-3544
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The aim of the present study was to identify cell types in primary culture from malignant and non-malignant effusions. Effusion samples were subjected to cytology and culture. Immunocytochemistry was performed in cytological slides to evaluate malignancy (positivity for malignancy markers) and in culture slides for identification of cell types in growth. A total of 143 effusion samples (pleural n=76; peritoneal n=37; pericardial n=4; and peritoneal lavage n=26) were analyzed. Cell growth was observed in 34.9% of all samples and immunocytochemistry for identification of cell types in culture slides was conclusive in 90% of them. In non-malignant samples (n=28), growth of mesothelial cells, macrophages and of both cell types was identified in 82.14, 10.71 and 7.14%, respectively. In malignant samples (n=17, all carcinomas), growth of malignant epithelial cells and of both malignant epithelial and mesothelial cells was identified in 41.17 and 23.52%, respectively. In the remaining 35.29% of malignant samples, the only cells in growth were mesothelial and/or macrophages instead of malignant epithelial cells. In conclusion, in culture of malignant effusions, mesothelial cells may be simultaneously identified with malignant epithelial cells. Besides, mesothelial cells and macrophages may be the only cells identified in malignant effusion culture. Therefore, a broad panel of cell markers should be used for unmistakable identification of cells in studies of effusion primary culture. The ideal malignant effusion sample to obtain culture of neoplastic cells should be that without the presence of mesothelial cells and macrophages.

In plain English

This laboratory study from Brasilia University Hospital in Brazil examined 143 fluid samples collected between 2012 and 2015. The samples came from around the lungs (pleural), the abdomen (peritoneal) and the heart (pericardial), plus peritoneal washings. The authors grew cells from the fluids in the laboratory for seven days and used antibody stains to tell the cell types apart. Cells grew in 50 of the 143 samples, and the stains identified the cell types in 45 of those 50. Of the 45, 17 were malignant (positive for carcinoma markers) and 28 were not. In the 28 non-malignant samples, the growing cells were mesothelial cells (cells that line body cavities) in 23, macrophages in 3 and both in 2. In the 17 malignant samples, malignant epithelial cells grew in 7, and malignant epithelial and mesothelial cells grew together in 4. In the other 6, only mesothelial cells and/or macrophages grew. The authors concluded that a broad panel of markers should be used to identify cells grown from such fluids. The study did not examine asbestos exposure or mesothelioma.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Laboratory study of clinical fluid samples: cytology, primary cell culture, and immunocytochemistry (antibody staining) to identify the cell types that grew
• Who was studied: 143 samples (pleural effusion n=76, peritoneal effusion n=37, pericardial effusion n=4, peritoneal lavage n=26) obtained at the Department of Pathology of Brasilia University Hospital, Brazil, between 2012 and 2015. In 47 of the 143 samples, the patients had a current or previous diagnosis of cancer (carcinoma n=45, lymphoma n=1, melanoma n=1).
• Main results:
  • Cells grew in 34.96% (50/143) of all samples. These were 31 pleural effusions and 19 peritoneal effusions.
  • Immunocytochemistry identified the cell types in 90% (45/50) of the samples that grew. Of these 45 samples, 17 were malignant (positive for carcinoma markers) and 28 were non-malignant.
  • In the 28 non-malignant samples, the cells that grew were mesothelial cells in 82.14% (23/28), macrophages in 10.71% (3/28) and both cell types in 7.14% (2/28).
  • In the 17 malignant samples, malignant epithelial cells grew in 41.17% (7/17). Both malignant epithelial and mesothelial cells grew in 23.52% (4/17).
  • In the remaining 35.29% (6/17) of malignant samples, only mesothelial cells and/or macrophages grew, with no malignant epithelial cells.
  • Under the microscope, growing mesothelial cells and malignant epithelial cells could not be told apart by appearance or size.
• The authors' conclusion: The authors concluded that, in cultures of malignant effusions, mesothelial cells may grow alongside malignant epithelial cells, or mesothelial cells and macrophages may be the only cells that grow. In their view, a broad panel of cell markers should therefore be used to identify cells in studies of effusion primary culture.
• Limitations the authors state:
  • The authors did not analyze marker expression beyond 2 and 7 days of growth.
  • Cells often failed to attach to the culture surface, which limited the number of samples that grew.
  • In 5 samples that grew, there were too few cells to run all the needed markers.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Cytology, Pericardial, Mesothelial Cells, Macrophage, Carcinoma.

Related studies

• IMP3/L523S, a novel immunocytochemical marker that distinguishes benign and malignant cells: the expression profiles of IMP3/L523S in effusion cytology — K. Ikeda, G. Tate, et al. (2010)
• Morphologic and immunocytochemical performances of effusion cell blocks prepared using 3 different methods — X. Jing, Q.K. Li, et al. (2013)
• The application of immunocytochemistry to direct smears in the diagnosis of effusions — S.M. Knoepp, J. Placido, et al. (2013)
• Small orangiophilic squamous-like cells: an underrecognized and useful morphological feature for the diagnosis of malignant mesothelioma in pleural effusion cytology — L. Chen, S.G. Caldero, et al. (2014)
• Investigating unilateral pleural effusions: the role of cytology — D.T. Arnold, D. De Fonseka, et al. (2018)
• Calretinin. A selective marker of normal and neoplastic mesothelial cells in serous effusions — M.C. Barberis, M. Faleri, et al. (1997)

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