Cytological and Immunohistochemical Diagnostics of Exudates in Ovarian Malignancies

The main difficulty in interpreting the cellular composition of exudates is the recognition of tumor cells against the background of proliferating mesothelium, which has different morphology. The aim of the work is to study the possibilities of cytological and immunohistochemical examination of ascitic fluid in various types of ovarian cancer. Morphological features of serous, endometrioid, mucinous and granulocellular types of ovarian cancer have been studied. A method for the diagnosis of ovarian cancer based on the results of microscopy of the cellular sediment of ascitic fluid on is described, histological diagnoses for each case are given. cytological glasses, on cell blocks, and based on data from immunohistochemical examination of the cell block material. The tables are compiled on the basis of data from sources 4-7 and our own research. The results of cytological and immunohistochemical studies with demonstration of microphotographs are shown using real examples from clinical practice. Results. An optimal panel of markers has been proposed for the diagnosis of common ovarian tumors in exudates based on our own immunohistochemical studies. Serous cancer tumor cells will be positive for WT1, PAX8, CA125, CK7 and Ber-EP4. Endometrioid ovarian cancer is characterized by a positive reaction to Ber-EP4, CK7, WT1 and CEA, focal expression of PAX8, Vimentin, ER and PR. Granulocellular tumor positively expresses Calretinin and Vimentin, negatively expresses Ber-EP4 and CK7, and often expresses WT1 in single cells. ER and PR can be positive in granulosa cells. Mucinous ovarian cancer rarely spreads into serous cavities, a positive reaction to Ber-EP4 and CK7, CEA and CDX2 has been described. For the differential diagnosis of this type of cancer, it is proposed to use ER and WT1. Mesothelial cells always express Calretinin and Vimentin, and are negative towards CK7 and Ber-EP4. Immunohistochemical examination of ascitic fluid is the most important diagnostic tool for determining the type of tumor in ascites.