Volume : 6, Issue : 8, August - 2017

Value of Claudin-4 Immunostaining in distinguishing Adenocarcinoma from Reactive mesothelium in Effusion fluid Cytology

Dr. Amit Pal, Dr. Jayati Chakraborty, Dr. Biswajit Biswas

Abstract :

<p>&nbsp;<b><span style="font-size: 14pt; line-height: 200%; font-family: &quot;Times New Roman&quot;, serif;">BACKGROUND- </span></b><span style="font-size: 14pt; line-height: 200%; font-family: &quot;Times New Roman&quot;, serif;">Morphological distinction between metastatic carcinoma cells &amp; reactive mesothelial cells is difficult in many occasions in effusion cytology. Immunohistochemistry plays important role in distinguishing the two.</span><span style="font-size: 14pt; line-height: 200%; font-family: &quot;Times New Roman&quot;, serif; color: rgb(35, 31, 32);"> Immunohistochemistry for claudin-4, &nbsp;has shown to distinguish adenocarcinoma from reactive mesothelium effectively.</span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;200%;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-size:&#10;14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">AIMS- </span></b><span style="font-size:14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;color:#231F20">Our aim was to validate and assess the Immunoreactivity profile of claudin-4 in a series of malignant and benign effusions.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;200%;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-size:&#10;14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">MATERIALS AND METHODS:-</span></b><span style="font-size:14.0pt;line-height:200%;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;"> Total 84 samples were taken, 38 containing reactive mesothelial cells &amp; 46 containing adenocarcinoma cells. <span style="color:#231F20">Claudin-4 immunohistochemistry was performed on cell-block paraffin sections and scored for staining intensity, staining pattern and percentage of positive tumor cells.<o:p></o:p></span></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;200%;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-size:&#10;14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">RESULTS-</span></b><span style="font-size:14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> In 46 cases of metastatic adenocarcinomas, 44 cases were positive for<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;200%;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:&#10;14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Claudin-4 &amp; among the 38 non-malignant effusion cases where the fluid contained<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;200%;mso-layout-grid-align:none;text-autospace:none"><span style="font-size:&#10;14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">reactive mesothelial cells, none of them were positive for Claudin-4. Sensitivity &amp; specificity of claudin-4 in diagnosing adenocarcinoma were 95.6% &amp; 100% respectively.Positive Predictive Value &amp; Negative Predictive Value of claudin-4 in diagnosing adenocarcinoma were 100% &amp; 95% respectively<b>.</b><o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;200%;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-size:14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;color:#231F20">CONCLUSIONS</span></b><span style="font-size:14.0pt;line-height:&#10;200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;color:#231F20">: Claudin-4 immunohistochemistry effectively distinguishes adenocarcinoma from reactive mesothelium with high sensitivity and specificity.<o:p></o:p></span></p>