Cytological objectified differential diagnostics of mesothelioma and reactive serositis

Мариненко С.В.1, Болгова Л.С.1, Гурьянов В.Г. 2

Summary. Mesothelioma is a rare malignant primary disease of serous membranes. Cytological diagnosis is established mainly for exudate materials, but differential diagnosis of mesothelioma and reactive serositis often causes difficulties. To determine the biological characteristics of altered mesothelium, additional methods of investigation — cytogenetic and immunocytochemical — were used. At cytogenetic determination of morphofunctional types of nuclear-forming regions of chromosomes, significant differences in the mesotheliomas for which a characteristic increase in the content of compact 0.29±0.03 (11.9±0.03%) and transitional nucleolonemas types 1.07±0.09 (40.3±2.0%), are established in comparison with reactive mesothelins to 0.03±0.01 (0.84±0.14%) and 0.29±0.03 (8.7±0.7%) (p<0.05). Immunocytochemical set for the mesothelioma cells characteristic positive reaction at the exposure of pancytokeratins (CK clone AE1/AE3) (94%), calretinin (62%), vimentin (56%), cytokeratin 5/6 (44%), and in the reactive mesothelial cells — vimentin (75%) and calretinin (75%), that allows to define the histogenesis of the studied cells. It is statistically well-proven that a cytogenetic method allows to conduct differential diagnostics of mesothelioma and reactive serositis with high authenticity: sensitiveness of test of 80% (95% CI 52–96%), specificity of 93% (95% CI 68–100%).
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