engleski

Tumor markers in the determination of cellular origin and primary focus of metastatic tumours

Metastatic tumours are frequently more vaguely differentiated or non-differentiated and, sometimes, it is difficult to determine the cellular origin based on the cytomorphologic picture, and even more complex, the primary focus of the tumour. Aims: (1) To analyse the possibility of determining cellular origin and primary focus of the metastatic process by adding the cellular markers to cytomorphology ; (2) to estimate the proliferation status and ploidy of vaguely differentiated metastatic tumours. Methods: The total of 1753 liver and lymph nodes aspirates have been analysed. The aspiration of localised lesions of liver and abdominal lymph nodes was performed by CHIBA needle controlled by ultrasound (US) or computerised tomography (CT), and of superficial lymph nodes by fine needle (FNA) under the US control or based on palpable finding. The preparations were stained by the May-Griinwald-Giemsa method, immunocytochemical treatment was performed by LSAB method monoclonal antibodies (DAKO). The proliferation status was determined in the analysis of the nuclear organiser region (AgNOR), and aneuploidy by the static DNA image cytometry, both by the SFORM programme (VAMSTEC brand from Zagreb). Results: Out of 678 liver aspirates, malignant lesions were dete ; ted in 404 ones. The primary tumours numbered 68, plus 336 metastatic ones (329 of epithelial, and 31 of mesenchymal and embryonal origin). Out of 1075 lymph nodes aspirates, in 540 cases malignant lesions were found (409 malignant lymphomas, 87 epithelial and 25 nonepithelial metastatic tumours, while in four cases the cellular origin couldn't be determined). All together, based on the morphologic picture and immunocytochemic treatment by mononucleal antibodies, the epithelial, mesenchymal or embryonal cellular origin could be determined in 99.1 % cases of all metastatic tumours, while in the epithelial tumours primary focus was recognised in 33.4% cases. In weakly differentiated tumours, the tumour aggressiveness was confirmed by high aneuploidy (DNA image cytometry) and by high proliferation status (AgNOR determination). The cellular markers are unreplaceable addition to the cytomorphologic picture in the determination of cellular origin of tumour cells. However, very often, specific tumour markers reveal tissue co-expression and, as a rule, are not typical for only one organ. Despite this, their combination improves the search for primary focus of the metastatic process or, possibly, determine the additional targeted diagnostic treatment (CT, US, MR, etc.).

Metastatic tumours and primary site; cytomorphology; tumour markers; immunocytochemistry

nije evidentirano