ABSTRACT
Objective: To differentiate between adenocarcinoma cells and reactive mesothelial cells [RMC] in serous effusions using a limited immuno-panel of Ber-EP4 and Calretinin
Study Design: Descriptive study
Place And Duration Of Study: Department of Pathology, Allama Iqbal Medical College, Lahore, in collaboration with the Departments of Surgery, Pulmonology and Oncology, Jinnah Hospital, Lahore, from March 2015 to March 2016
Methodology: Ninety-seven clinically and radiologically proven cases of peritoneal and pleural effusion and peritoneal wash of patients with suspicion of malignancy were included in the present study. Diagnostic accuracy of a limited immuno-panel of Calretinin and Ber-EP4 for diagnosis of malignant effusions was calculated using histopathology as gold standard
Results: The sensitivity of Ber-EP4 for malignant cases was 98.6%, specificity 100%, positive predictive value [PPV] 100%, negative predictive value [NPV] 96%, and diagnostic accuracy 98.9%. Sensitivity of Calretinin as positive staining for RMC was 79.2%, specificity and positive predictive value [PPV] 100%, negative predictive value [NPV] 93.6%, and diagnostic accuracy 94.8%
Conclusion: Limited immuno-panel of Calretinin and Ber-EP4 had a high positive and negative predictive value and is cost-effective in resource limited set-up for identification of adenocarcinoma cells and reactive mesothelial cells in challenging cases of serous effusions