Additional techniques in serous effusions

Our plain-English summary of Additional techniques in serous effusions, by A.G. Hanselaar (Analytical Cellular Pathology, 2002).

The study

• Author: A.G. Hanselaar
• Journal: Analytical Cellular Pathology
• Published: 2002;24(1):1-4
• Type of article: Comment, Editorial, Review
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Cytological examination is a valuable diagnostic tool in case of a serous effusion. The first manifestation of malignancy may be an effusion of the pleural, pericardial, or peritoneal cavity, especially in carcinoma of the ovary, or lung, and malignant mesothelioma. In other malignancies effusions may occur in the course of the disease. The contribution by Mother by et al. in this issue of ACP focuses on the contribution of image and flow cytometry to establish the presence or absence of malignancy in serous effusions. They point out that the sensitivity of DNA image cytometry in equivocal effusions may be as high as 87.5%, and that for the detection of malignancy, DNA image cytometry is superior to flow cytometry.

In plain English

This article was an editorial, not a research study. The author introduced a study by Motherby et al., published in the same issue of the journal, on using DNA image cytometry and flow cytometry to establish the presence or absence of malignancy in serous effusions. Serous effusions are fluid collections in the pleural (chest), pericardial (around the heart) or peritoneal (abdominal) cavities. The editorial mentioned asbestos only once, describing malignant mesothelioma as known for its causal relationship with asbestos. According to the editorial, Motherby et al. reported that routine cytology had a sensitivity of 58%. That figure rose to 87.5% when DNA image cytometry was performed, with a specificity of 100%. In effusions that were equivocal on cytology, sensitivity was 75%, at the same 100% specificity. Motherby et al. also found DNA image cytometry far superior to flow cytometry for detecting malignancy. The editorial noted an earlier study by Decker et al. that reported 98.5% sensitivity and 100% specificity when cytology was combined with image DNA cytometry. The author concluded that accurate diagnosis of a serous effusion mandates ancillary methods such as immunocytochemistry and image DNA analysis.

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: Editorial commenting on a study by Motherby et al. in the same journal issue and on other diagnostic techniques for serous effusions
• Who was studied: No study population of its own; the editorial discusses the Motherby et al. study and earlier published studies
• Exposure: Not an exposure study; asbestos is mentioned only as the known cause of malignant mesothelioma, as background
• Main results:
  • As reported by Motherby et al. (not this editorial), routine cytological examination had a sensitivity of 58%, which rose to 87.5% by performing DNA image cytometry, at a specificity of 100%
  • As reported by Motherby et al., in effusions that were equivocal on cytology the sensitivity of DNA image cytometry was 75%, at the same specificity of 100%
  • As reported by Motherby et al., DNA image cytometry was far superior to flow cytometry for detecting malignancy
  • An earlier study by Decker et al., cited in the editorial, reported a sensitivity of 98.5% and a specificity of 100% for cytology combined with image DNA cytometry
  • An earlier study by Kayser et al., cited in the editorial, noted that 40% of effusions did not meet the technical requirements for image DNA cytometry
• The authors' conclusion: The author concluded that accurate diagnosis of a serous effusion mandates ancillary methods such as immunocytochemistry and image DNA analysis, and that the value of flow cytometry for this task is limited

Topics

Medical terms in this study, explained in our Lexicon: Pericardial, Peritoneal Cavity, Carcinoma, Mesothelioma.

Related studies

• Diagnostic DNA-flow- vs. -image-cytometry in effusion cytology — H. Motherby, N. Pomjanski, et al. (2002)
• Cytological differential diagnosis among adenocarcinoma, epithelial mesothelioma, and reactive mesothelial cells in serous effusions by immunocytochemistry — X.Y. Su, G.D. Li, et al. (2011)
• The diagnostic role of BAP1 in serous effusions — B. Davidson, M. Tötsch, et al. (2018)
• MMP-7 is a highly specific negative marker for benign and malignant mesothelial cells in serous effusions — B. Davidson, H.T. Stavnes, et al. (2016)
• Immunocytochemistry and DNA-image cytometry in diagnostic effusion cytology I. Prevalence of markers in tumour cell positive and negative smears — H. Motherby, M. Kube, et al. (1999)
• Diagnostic and prognostic value of Ki67 proliferation fraction in serous effusions — A. Schönherr, M. Bayer, et al. (2004)

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