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Analytical Cellular Pathology
Volume 19, Issue 2, Pages 59-66

Immunocytochemistry and DNA-image Cytometry in Diagnostic Effusion Cytology. II. Diagnostic Accuracy in Equivocal Smears

Helma Motherby,1 Nicolaus Friedrichs,1 Mary Kube,1 Bahram Nadjari,1 Kristiane Knops,1 Andreas Donner,2 Betty Baschiera,3 Peter Dalquen,3 and Alfred Böcking1

1Institute of Cytopathology, Heinrich Heine University, Moorenstr. 5, D‐40225 Düsseldorf, Germany
2Institute of Pathology, Heinrich Heine University, Moorenstr. 5, D‐40225 Düsseldorf, Germany
3Division of Cytopathology, Institute of Pathology, University Hospital Basel, Schönbeinstr. 40, CH‐4003 Basel, Switzerland

Received 18 February 1999; Accepted 10 June 1999

Copyright © 1999 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


To determine sensitivity and specificity of different antibodies for the immunocytochemical detection of malignant cells in diagnostically equivocal effusions in comparison with those achieved by DNA‐image cytometry. 65 cytologically doubtful effusions of the serous cavities were stained with twelve antibodies. Furthermore, DNA‐image cytometry was performed. Data were correlated with patient follow‐up. Sensitivity of cellular staining of Ber‐EP4 for the identification of malignant cells was 77.8%, specificity of absent staining for benign cells was 100%. Positive predictive value for the identification of malignant cells was 100%, negative value 65.5%. Sensitivity of DNA‐aneuploidy for the identification of malignancy was 82.9%, specificity of DNA‐non‐aneuploidy for benignity 94.7%. The positive predictive value of DNA‐aneuploidy for the occurrence of malignant cells was 96.7%. Negative predictive value of DNA‐non‐aneuploidy was 72.0%. Combining immunocytochemistry applying Ber‐EP4 only and DNA‐cytometry in equivocal effusions resulted in a sensitivity of 88.9% for the identification of malignant cells associated with a 95.0% specificity. Positive predictive value was 97.7%, the negative one 79.2%.