The most common first symptom of ovarian cancer (OC) is the accumulation of serous fluid in the abdominal cavity. Morphological verification is necessary to resolve the issue of the nature of the process and the purpose of treatment. Cytological examination (CE) of ascitic fluid is a subjective method based on the knowledge and experience of a morphologist. The use of a comprehensive assessment of the CE with subsequent immunocytochemical (ICH) revision is a trend of modern diagnostics, and the use of test systems for the diagnosis of ICH, focused on one patient, will increase the availability of this type of study in the primary polyclinic. The aim of the work is to evaluate the diagnostic informativeness of using the SER 1 test system in the biochip format to determine the expression of EpCAM protein in ascitic fluid cells in the detection of OC.
70 samples of ascitic fluid obtained from patients with suspected OC who sought planned or emergency medical care at the surgical hospital of Nizhny Novgorod City Hospital No. 35 in 2021 were analyzed. All samples of ascitic fluid were examined cytologically. Using the SER1 test system (RUSSELL LLC, Russia), an ICH study was conducted, the results of which were visualized using a Zeiss Primo Star microscope (Carl Zeiss, Germany). The findings were classified in accordance with the International Cytological Classification of Effusion Fluids (TIS RSFC).
During CE, data were obtained: non-diagnostic material (ND) - 11.4%, absence of malignant cells (NFM) - 44.3%, presence of cells with atypia of unclear significance (AUS) - 10%, suspicion of cancer (SFM) - 20%, malignant nature of cells (MAL) - 14.3%. An additional ICC study of EpCAM protein expression on SER 1 test systems changed the results within the categories: NFM - 58.6%, AUS - 0%, SFM - 2.8%, MAL - 27.2%.
A comprehensive assessment of the CE of effusion fluids, supplemented by ICH staining, increases the detectability of malignant tumor cells by 1.9 times, reducing the number of conclusions in the AUS,SFM categories. The use of the SER1 test system introduces ICH research into the practice of primary hospitals that do not belong to the oncology profile and contributes to the earlier diagnosis of OC.
The authors.
Russell Llc, Russian Federation.
All authors have declared no conflicts of interest.