Cytological method of diagnostics of pleural effusion using immunocytochemical and molecular genetic techniques

Abstract

The aim of the study is to estimate the potentiality of using immunocytochemical and molecular genetic techniques in diagnosis of patients with pleural effusion. Materials and methods. The results of a cytological study of 580 patients with pleural effusion examined in the Altai Regional Oncological Dispensary in 2019 were evaluated. Immunocytochemical and molecular genetic techniques were applied using cytological specimens prepared from pleural fluid. Epidermal growth factor receptor (EGFR) gene status was determined. Results. Non-tumor pleural effusion was diagnosed in 378 cases (65%). Tumorous cells of 181 (31%) patients were found in pleural effusion. It was very difficult to diagnose a pathological process by cell composition in 21 (4%) cases because of the inability to distinguish histiocytes and mesothelial cells from tumor cells using light microscopy. Immunocytochemical researches of 105 patients with pleural effusion were used for specification of metastases and in uncertain diagnostic cases. EGFR gene mutation for the diagnosed pulmonary adenocarcinoma had been determined in 31 cases for proper assignment of the target medicines. Dotty L858R mutation and deletions 19 exon were detected. Conclusions: Light microscopy allowed us to differentiate tumor and non-tumor plural effusion in 96% of cases. Immunocytochemical technique revealed the primary tumor site in 95% of cases of pleural effusions. Cytological specimens are full-advantaged material for molecular genetic technique. Mutations were found in 19% of cases.

Keywords

pleural effusion / cytological researches / immunocytochemical and molecular genetic techniques

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