Immunocytochemistry and DNA-image cytometry in diagnostic effusion cytology. II. Diagnostic accuracy in equivocal smears

Anal Cell Pathol. 1999;19(2):59-66. doi: 10.1155/1999/934146.


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%.

MeSH terms

  • Aneuploidy
  • Antibody Specificity
  • Ascitic Fluid / pathology
  • DNA, Neoplasm / analysis*
  • Follow-Up Studies
  • Heart Neoplasms / pathology
  • Humans
  • Image Cytometry / methods*
  • Image Cytometry / standards
  • Immunohistochemistry / methods*
  • Immunohistochemistry / standards
  • Lung Neoplasms / pathology*
  • Neoplasm Proteins / analysis
  • Neoplasm Proteins / immunology
  • Pericardial Effusion / pathology
  • Peritoneal Neoplasms / pathology
  • Pleural Effusion / pathology*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Staining and Labeling / methods
  • Staining and Labeling / standards


  • DNA, Neoplasm
  • Neoplasm Proteins