TUMOR ONCOGENIC EXPRESSION IN MALIGNANT EFFUSIONS AS A POSSIBLE METHOD TO ENHANCE CYTOLOGIC DIAGNOSTIC SENSITIVITY - AN IMMUNOCYTOCHEMICAL STUDY OF 87 CASES

The diagnostic ability of cytological preparations can be hampered by specimen inadequacy and the presence of representative cells, which ma y result in a diagnostic accuracy of only 70%. An immunocytochemical b attery (ICC), which included anti-p53, anti-c-er6B-2, and B72.3 MoAbs, was used to enhance sensitivity in 87 specimens of body effusions. Th irty-six cases were positive for malignancy using conventional cytolog y. Forty cases were negative and 11 cases were inconclusive or had an equivocal diagnosis. Sensitivity was 65%, and there was a negative pre dictive value (NPV) of 62%. p53 was expressed in 50 cases (56%, sensit ivity = 83%, NPV = 73%), and B72.3 MoAb was positive in 36 cases (37%, sensitivity = 66%, NPV = 64%), Forty-eight cases (56%) displayed reac tivity with anti-c-erbB-2 (sensitivity = 75%, NPV = 63%). The authors concluded that application of an ICC panel of anti-p53, B72.3 and c-er bB-2 to complement conventional cytology increases sensitivity to 98% (P <.0005) with an NPV of 96% (P =.001).