Routine DNA cytometry of benign and malignant pleural effusions by means of the remote quantitation server Euroquant: a prospective study

Aim-To analyse the practicability and potential assistance of static DNA cy tometry performed by means of the remote quantitation server Euroquant and the internet in routine diagnostic analysis of pleural effusions, and to ou tline the role of DNA cytometry on pleural effusions in distinguishing betw een benign and malignant land herein primary versus metastatic) effusions. Materials and methods-Cytological smears of 294 pleural effusions were stai ned with the Feulgen method. The DNA content of a minimum of 300 randomly c hosen analysis nuclei and 30 reference nuclei (lymphocytes) was measured by internet connection to the remote quantitation server Euroquant. Cytometri c features were derived from the histograms, and the time needed for case e valuation, the reliability of staining and measurement procedures, and the contribution to the final diagnosis were evaluated. Results-Only 120 of 294 pleural effusions could be measured. The total meas urement time for each specimen was 60 minutes. The guidelines of the consen sus report on DNA measurements were fulfilled. Seventy eight malignant (18 mesotheliomas, 60 metastatic tumours) and 42 benign effusions were measured . Seven of 18 malignant effusions were euploid and none of 42 benign effusi ons were aneuploid. The sensitivity and specificity were 91% and 100%, resp ectively, for distinguishing benign from malignant effusions, and 95% and 1 00%, respectively, for discriminating between benign and malignant effusion s caused by metastatic malignant tumours. Conclusions-Static DNA cytometry using the remote quantitation server Euroq uant can be performed reliably in the routine diagnosis of pleural effusion s; however, only 40% of effusions meet the technical requirements for stati c DNA cytometry. Within the measurable cases, static DNA cytometry made an important contribution to the confirmation! exclusion of malignancy.