Thursday, October 20th, 2005.

Diagnostic Cytopathology. Volume 33, Issue 5 , Pages 325 - 331. Published Online: 20 Oct 2005. [Link]

Eva Sigstad, M.D. ¹, Hiep Phuc Dong, CT ¹, Søren Nielsen, CT ², Aasmund Berner, M.D., Ph.D. ¹, Ben Davidson, M.D., Ph.D. ¹, Björn Risberg, M.D., Ph.D. ^{1 *}

1. ¹Department of Pathology (Section of Cytology), the Norwegian Radium Hospital, Oslo, Norway
2. ²Department of Pathology, Aalborg Hospital, Aalborg, Denmark

email: Björn Risberg (brisberg@labmed.uio.no)

^*Correspondence to Björn Risberg, Department of Pathology (Section of Cytology), The Norwegian Radium Hospital, Montebello, N-0310 Oslo, Norway

Abstract

We have previously shown that flow cytometric (FCM) immunophenotyping is a useful adjunct to morphology, in the diagnosis of serous effusions. The objective of the present study was to evaluate the possible application of FCM to quantitative analysis of adhesion molecule expression in this clinical setting. Fresh frozen cells from 67 effusions underwent quantitative analysis of V, 6, 1, and 3 integrin subunit expression, using FCM. Specimens were diagnosed as carcinoma (n = 48), reactive (n = 12), or malignant mesothelioma (MM; n = 7) using morphology and, in selected cases, immunocytochemistry prior to FCM analysis. Antibodies against established epithelial, lymphoid, and mesothelial cell epitopes (Ber-EP4, anti-epithelial membrane antigen; (EMA), anti-CD45, anti-CD14, and anti-CD15) completed the panel. Results (percentage of cells expressing the antigen) were analyzed for relationship with the morphologic diagnosis. Frequent expression of the V, 6, and 1 subunits was seen in all diagnostic groups, with significantly higher expression of the 6 subunit in MM (P = 0.029, Kruskal-Wallis H test). The 3 integrin subunit was not detected in any of the specimens. Ber-EP4 and CD15 expression was significantly higher in carcinomas compared with reactive effusions and MM (P < 0.001 and P = 0.001, Kruskal-Wallis H test), and EMA expression was higher in carcinomas and MM, compared with reactive specimens (P < 0.001, Kruskal-Wallis H test). In conclusion, FCM is an efficient tool for quantitative analysis of adhesion molecules in effusions. The high 6 integrin subunit expression in MM suggests involvement of this receptor in tumor attachment to laminin. The frequent expression of the V and 1 subunits support attachment to fibronectin and vitronectin as the major ECM ligands in body cavities.

Glossary

diagnosis

identifying a disease by its signs or symptoms, and by using imaging procedures and laboratory findings. The earlier a diagnosis of cancer is made, the better the chance for long-term survival.

cytology

(cy-tahl-uh-gee) the branch of science that deals with the structure and function of cells.

cell

the basic unit of which all living things are made. Cells replace themselves by splitting and forming new cells (mitosis). The processes that control the formation of new cells and the death of old cells are disrupted in cancer.

carcinoma

(car-sin-o-ma) a malignant tumor that begins in the lining layer (epithelial cells) of organs. At least 80% of all cancers are carcinomas.

antigen

(an-tuh-jen) a substance that causes the body's immune system to react. This reaction often involves production of antibodies. For example, the immune system's response to antigens that are part of bacteria and viruses helps people resist infections. Cancer cells have certain antigens that can be found by laboratory tests. They are important in cancer diagnosis and in watching response to treatment. Other cancer cell antigens play a role in immune reactions that may help the body's resistance against cancer.

tumor

an abnormal lump or mass of tissue. Tumors can be benign (not cancerous) or malignant (cancerous).

mesothelioma

a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.

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