Possibilities of cytological diagnosis of the nature of the exudate at the stage of emergency.

Abstract

Cytological diagnosis by effusions is currently the only reliable method of morphological verification of the diagnosis, it has prognostic significance and determines the choice of treatment strategy. At the same time, the variability of normal mesothelial cells causes significant difficulties in its differential diagnosis with reactive mesothelium, malignant mesothelioma and cancer metastasis, which requires additional analytical methods. A retrospective study of cytological preparations for 2017 was conducted, as well as the effectiveness of the use of fluorescent immunocytochemistry (FITZ) on the test system "biochip" in combination with a traditional cytological study was evaluated. During the period of November 2017 - July 2018, 46 exudates of serous cavities were studied, which showed that 9 patients (19.6%) were diagnosed with metastatic effusion, 31 (66.7%) patients had reactive exudate, suspicion of the malignant nature of serous fluid was expressed in 4 patients (8.7%), and 4.8% of persons (2 samples) failed to make an accurate diagnosis. After an additional FITZ study using the "Biochip" test system, the number of patients diagnosed with metastatic effusion increased to 7 (25.9%) due to a decrease in the percentage of cases of unspecified effusion. The combined use of traditional cytology and fluorescent immunocytochemistry in the diagnosis of effusion fluids at the stage of emergency medical care to the patient complements each other and contributes to a faster and more reliable diagnosis, as it allows to confirm the malignancy of the test material, and to assume the primary focus.