Introduction: Malignant serous effusions are common in metastatic carcinomas. Although cytomorphology is recognized as the gold standard diagnostic method, it exhibits moderate sensitivity. This study aimed to assess the diagnostic value of immunophenotyping with a single epithelial marker, known as the epithelial cell adhesion molecule (EpCAM, CD326), in discriminating malignant metastatic carcinomas of serous fluids. Methods: This prospective study was conducted on suspicious or confirmed cases of malignant tumors from September 16, 2019, to June 21, 2020. Serous fluid samples were assessed via cytomorphology using the Wright-Papanicolaou method and the anti-EpCAM mouse monoclonal antibody (clone VU-1D9) flow cytometry. The EpCAM(+)/CD45(−) immunophenotype was defined as the metastatic involvement of carcinoma in the serous cavity. Results: A total of 118 samples (90 females and 28 males; mean age, 54.04 ± 16.14 years), collected from peritoneal and pleural fluids, were examined in this study. Five samples (4.24%) were positive in both EpCAM flow cytometry and cytology, while 102 samples (86.44%) were negative for both EpCAM flow cytometry and cytology, yielding an overall agreement of 92%, 84%, and 90.7% for the peritoneal, pleural, and total samples, respectively. Based on the Bayesian latent class model, the EpCAM flow cytometry showed sensitivity and specificity of 58.5% (95% CI: 0.3, 99.7) and 96.2% (95% CI: 47.8, 100), respectively. The corresponding values were 68.7% (95% CI: 0.3, 99.9) and 96.1% (95% CI: 47, 100) for cytology, respectively. Conclusion: The EpCAM flow cytometry and cytology showed comparable performance in detecting metastatic effusions. The EpCAM flow cytometry might have a diagnostic value in decreasing the false-negative rate of cytomorphology, while maintaining excellent specificity.
Acta Cytologica

中文翻译：

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上皮细胞粘附分子流式细胞仪对浆液性转移癌诊断的价值

简介：恶性浆液性渗出液在转移性癌中很常见。尽管细胞形态学被公认为金标准诊断方法，但它表现出中等敏感性。本研究旨在评估使用称为上皮细胞粘附分子（EpCAM，CD326）的单一上皮标记物进行免疫表型分析在鉴别浆液性恶性转移癌中的诊断价值。方法：这项前瞻性研究是在 2019 年 9 月 16 日至 2020 年 6 月 21 日期间对可疑或确诊的恶性肿瘤病例进行的。使用 Wright-Papanicolaou 方法和抗 EpCAM 小鼠单克隆抗体（克隆 VU- 1D9) 流式细胞术。EpCAM(+)/CD45(-) 免疫表型被定义为浆液腔中癌的转移受累。结果：本研究共检查了 118 个样本（90 名女性和 28 名男性；平均年龄，54.04 ± 16.14 岁），从腹膜液和胸膜液中采集。5 个样本 (4.24%) 在 EpCAM 流式细胞术和细胞学上均为阳性，而 102 个样本 (86.44%) 在 EpCAM 流式细胞术和细胞学上均呈阴性，腹膜的总体一致性分别为 92%、84% 和 90.7% ，胸膜和总样本，分别。基于贝叶斯潜在类别模型，EpCAM 流式细胞仪的灵敏度和特异性分别为 58.5%（95% CI：0.3、99.7）和 96.2%（95% CI：47.8、100）。细胞学的相应值分别为 68.7%（95% CI：0.3、99.9）和 96.1%（95% CI：47、100）。结论：EpCAM 流式细胞术和细胞学在检测转移性积液方面表现出相当的性能。EpCAM 流式细胞术可能在降低细胞形态学假阴性率方面具有诊断价值，同时保持出色的特异性。
细胞学报