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Slide‐based cytometry for predicting malignancy in solid salivary gland tumors by fine needle aspirate biopsies
Author(s) -
Gerstner Andreas O. H.,
Müller AnneKathrin,
Machlitt Julia,
Tárnok Attila,
Tannapfel Andrea,
Weber Anette,
Bootz Friedrich
Publication year - 2003
Publication title -
cytometry part b: clinical cytometry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.646
H-Index - 61
eISSN - 1552-4957
pISSN - 1552-4949
DOI - 10.1002/cyto.b.10037
Subject(s) - pathology , malignancy , histopathology , salivary gland , fine needle aspiration , cytokeratin , cytometry , biopsy , medicine , biology , flow cytometry , immunohistochemistry , microbiology and biotechnology
Background To minimize hospitalization and morbidity for a patient with a solid tumor of a salivary gland, malignancy must be confirmed or excluded as soon as possible. This information cannot be obtained preoperatively by existing standard procedures. Minimal‐invasive approaches with adequate diagnostic analysis represent a promising precondition for optimized therapy. Methods For fine needle aspirate biopsies (FNABs), laser scanning cytometry (LSC) offers a semi‐automated slide‐based technology for objective and quantitative analysis. We have established an assay for FNABs from salivary gland tumors. FNAB cells were stained for cytokeratin and DNA followed by LSC analysis. The cells were subsequently HE‐stained and were relocalized on the slide. The LSC analysis quantitatively determines the DNA index (DI) of the tumor cells taking leukocytes as internal DNA diploid standard. Histograms with 0.95 < DI < 1.05 and 1.9 2.5 (i.e., 5c exceeding rate, 5cER) was calculated. Samples with DNA aneuploid peaks or with 5cER > 5% were classified as malignant. Routine histopathology was performed as a control. Results FNABs from 51 solid salivary gland tumors (41 parotid gland, six submandibular, four parapharyngeal) were analyzed with this assay. Eleven of 14 malignant tumors were DNA aneuploid by LSC analysis. All benign tumors showed diploid DNA content. The positive predictive value for malignancy was 1.0, the negative predictive value was 0.93, the correlation with routine histopathology was highly significant ( p = 7.6 × 10 ‐9 , Fisher's exact test). The calculated specificity of LSC analysis was 1.0 and the sensitivity was 0.79. Conclusions This pilot study demonstrates the validity of slide‐based cytometry for the preoperative prediction of malignancy in solid tumors being inaccessible for incision biopsy but suitable for FNABs such as those of the parotid gland. Cytometry Part B (Clin. Cytometry) 53B:20–25, 2003. © 2003 Wiley‐Liss, Inc.