Clinical value of DNA image cytometry in effusions with atypia

Malignant cells in serosal effusions provide essential information about th e extent of malignant disease. The main aim of this study was to examine th e additional diagnostic value of DNA image cytometry for cases with uncerta inty in the cytological diagnosis. In addition, the feasibility of automate d nuclei detection was investigated. Out of 457 cases, 33 samples in 32 pat ients were diagnosed with "atypia" (probably benign) and 21 as "suspicious for malignancy." DNA image cytometry was performed on these 54 cases and on an additional group of 14 cytologically malignant cases. The results show that automatic classification is useful for separation of control cells, i.e., lymphocytes and neutrophilic granulocytes from other m ononuclear cells. In 21 cases an insufficient number of control cells were measured. Seventy-two percent of the cytologic malignant cases were aneuplo id. In contrast, in none of the cases with "atypia" and in only 2 of the ca ses "suspicious for malignancy" was aneuploidy present (2 of the remaining 32, 6%). From the cases with follow-up, a malignancy in the pleural fluid w as present in 2 out of 17 cases with "atypia" and in 5 out of 10 with a "su spicious for malignancy" cytologic diagnostics, respectively. In conclusion , the additional diagnostic value of DNA image cytometry in cases with a cy tological diagnosis of "atypia" or "suspicious for malignancy" is limited. Diagn. Cytopathol. 1999:21:112-116. (C) 1999 Wiley-Liss, Inc.