Multi-color / target fluorescence in situ hybridizatio(Mt -FISH)法及び免疫染色(ICC)法を用いた腹腔細胞診の検討

Abstract

Introduction: Utility of Mt-FISH analysis in peritoneal cytology has not been well elucidated so far. In the present study，therefore，peritoneal cytology in 63 patients with malignant and non-malignant diseases was studied in different three methods，Papanicolaou and Giemza cytology (Pap)，ICC，and Mt-FISH，to evaluate the utility and availability of ICC and Mt-FISH in peritoneal cytology. Materials and methods: Peritoneal cytology specimens of 63 patients were collected from the files of the Pathology Section，Nara Medical University Hospital，including 54 cases of adenocarcinoma (33 of gastrointestinal or biliary, 18 ovarian or endometrial, and 3 primary peritoneal cancers) and 9 cases of benign lesions (6 benign tumors and 3 non-tumor lesions). Results of the three different methods were evaluated and compared. Results: Incidence of positive malignancy rate was 20% (11/54) in Pap method，36% (18/50) in ICC，and 59% (20/34) in Mt-FISH. When compared to Pap method, sensitivity and accuracy were statistically significantly higher in Mt-FISH, but not in ICC. No inadequate or insufficient specimens were found in Pap method, but these were found in 6% of lavage cytology and 8% of ascitic cytology in ICC specimens and 14% of lavage cytology and 31% of ascitic cytology in Mt-FISH specimens, respectively. Conclusion: ICC and Mt-FISH methods are very useful additional methods for accurate diagnosis of peritoneal cytology. But the incidence of inadequate or insufficient cytology specimens was higher in Mt-FISH of ascitic cytology, and the methods of processing the ascitic fluid for Mt-FISH must be improved and are now under consideration.