Evaluation of immunofluorescence cytochemical staining and laser-scanning confocal microscopy in the diagnosis of meningeal carcinomatosis

Objective To explore the value of combination of immunofluorescence cytochemical staining (ICS) and laser-scanning confocal microscopy (LSCM) in the diagnosis of meningeal carcinomatosis. Methods ICS and LSCM were used to detect the cellular distribution and quantity of epithelial membrane antigen (EMA) in cerebrospinal fluid (CSF) cells of patients with meningeal carcinomatosis (MC group) and controls (control group). Results The EMA was expressed with red fluorescence in the cytoplasm of meningeal carcinomatosis cells. The mean fluorescent intensity of cellular EMA in meningeal carcinomatosis cells of CSF in MC group (44.84 ± 13.05) was significantly higher than the cells of CSF in control group (3.98 ± 1.58; t = 43.954, P = 0.001). The positive rate of routine cerebrospinal fluid cytologic examination (May-Grunwal-Giemsa staining) and EMA immunofluorescence examination combined LSCM was 60% (12/20) and 90% (18/20), respectively, the difference was significant ( χ 2 = 4.800, P = 0.010). Conclusion The combination of immunofluorescence cytochemical staining and LSCM for the detection of EMA expression changes in cells of CSF is useful for the diagnosis and differential diagnosis of meningeal carcinomatosis. DOI：10.3969/j.issn.1672-6731.2011.05.01