The accuracy of ascites cytology in diagnosis of advanced ovarian cancer in postmenopausal women prior to neoadjuvant chemotherapy

Saher Baransi, Nadav Michaan, Limor Gortzak-Uzan, Asaf Aizic, Ido Laskov, Ronni Gamzu, Dan Grisaru*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective:To evaluate the accuracy of ascites cytology in the diagnosis of epithelial ovarian cancer among postmenopausal women.Methods:Ascites samples of women older than 51 years sent for cytology evaluation at our institution between 2010 and 2015 were retrospectively compared to final histology. The sensitivity, specificity, negative, and positive predictive values were calculated. Immunohistochemistry stain results were collected to determine diagnostic profiles.Results:A total of 551 patients, 51 years and over had both cytology and diagnostic histology samples. Of those, 161 patients had pathology confirmed ovarian tumors, 155 of which were malignant. Of the 155 cases of ovarian cancer, 125 patients had malignant cells on cytology examination (true positive); in 30 cases, ascites was negative for malignancy (false negative). In six cases both ascites and final pathology were negative for malignancy (true negative). There were no cases of positive cytology and negative final pathology (ie, no false-positive cases). The sensitivity, specificity, positive, and negative predictive value for cytology diagnosis of ovarian cancer were 80.6%, 100%, 100%, and 16.7%, respectively. Immunohistochemistry was done on cell blocks in 79 cases of ovarian cancer, 75 (94.9%) had profiles diagnostic for ovarian origin.Conclusions:Ascites cytology for postmenopausal women older than 51 years with immunohistochemistry is highly accurate in diagnosis of ovarian cancer. Neoadjuvant chemotherapy can be safely prescribed based on paracentesis evaluations.

Original languageEnglish
Pages (from-to)771-775
Number of pages5
JournalMenopause
Volume27
Issue number7
DOIs
StatePublished - 23 Jul 2020
Externally publishedYes

Keywords

  • Ascites
  • Cytology
  • Epithelial ovarian cancer
  • Immunohistochemistry
  • Malignancy
  • Postmenopausal

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