STAGES OF CYTOLOGICAL EXAMINATION (USING IMMUNOCYTOCHEMICAL EXAMINATION) OF EFFUSION FLUIDS

Abstract

Relevance: Cytological criteria of tumors in exudate fluids are associated with specific subjective difficulties, one of which is the differential diagnosis of proliferating mesothelial and adenocarcinoma cells.
 The study aimed to: increase the informational value of cytological diagnostics in a multidisciplinary hospital.
 Methods: From 2018 to 2021, 10,082 serous cavity effusions (pleural – 8,166 (81%), abdominal cavity – 1,512 (15%), pericardial – 404 (4%)) were included in the cytological examination. Microscopic examination of traditional preparations was carried out, and immunocytochemical (ICC) examination was carried out in difficult diagnostic situations.
 Results: In this study, in women, the traditional cytological examination of effusion fluids revealed metastatic lesions of the serous cavities in 672 cases (58%), mainly due to breast cancer progression (26%). In men, pleurisy was primarily due to metastasis of adenocarcinoma of the lung – 266 cases (23%). ICC research increased the diagnostic accuracy of cytological examination by 62-93% and the specificity – by 95-99%.
 Conclusion: An algorithm for conducting ICH studies, differing in the number of panels of monoclonal antibodies used to determine the histological form and organ — the source of the tumor, has been developed. In specific cases, conducting ICR studies with 2-3 monoclonal antibodies may be enough to confirm the histological form of cancer and, where necessary, perform additional ICR studies without significant loss of time for obtaining results.