Complex cytological and immunocytochemical study of cerebrospinal fluid in the intracranial breast carcinoma metastases diagnosis

Introduction. Metastases of breast cancer are detected in 5 to 48% cases, depending on the biological tumor subtype, which is the second most common after lung cancer in men. Cytological liquor analysis is one of the “gold standards” for the metastatic brain lesion identification, and, among other modern approaches, it can increase the CNS metastasis detection. Breast cancer cell identification in cerebrospinal fluid is a poor prognostic factor. A cytological examination has a predictive significance for these patients: the absence of tumor cells in the cerebrospinal fluid can be considered the sign of the intrathecal therapy effectiveness. The accuracy of the cytological diagnosis directly depends on the detailed patient’s history. Immunocytochemical assays increase the sensitivity of the cytological diagnostics. The aim of the study was to evaluate the ca-pabilities of comprehensive cytological and immunocytochemical studies in the secondary cerebral lesions diagnosis in breast cancer patients. Materials and methods. We conducted 169 cytological studies in 55 breast cancer patients with brain metas-tases. Liquor samples were obtained using lumbar punctures. 36 patients underwent 44 immunocytochemical studies and 117 immunocytochemical reactions to clarify the cytological diagnosis. Results. The sensitivity of the cytological method was 69.8%. Immunocytochemistry increased the sensitiv-ity to 72.3%. In 29 patients, the tumor histogenesis was determined using an immunocytochemical assay. Conclusion. The liquor cytological analysis is frequently the only primary morphologic diagnostic method to detect breast cancer metastasis within the central nervous system. Immunocytochemical assay significantly expands the possibilities of cytological study, allowing health care specialists to detect single tumor cells in samples and determine the metastatic neoplasm histogenesis in most cases, which also increases sensitivity. Keywords: breast cancer, cytological and immunocytochemical study of cerebrospinal fluid