{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T17:50:40Z","timestamp":1764784240719,"version":"3.40.4"},"reference-count":36,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T00:00:00Z","timestamp":1564099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T00:00:00Z","timestamp":1564099200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Cytologica"],"published-print":{"date-parts":[[2020]]},"abstract":"<b><i>Background:<\/i><\/b> Differentiating reactive mesothelial cells from metastatic carcinoma in effusion cytology is a challenging task. The application of at least 4 monoclonal antibodies including 2 epithelial markers (Ber-EP4, MOC-31, CEA, or B72.3) and 2 mesothelial markers (calretinin, WT-1, CK5\/6, or HBME-1) are often useful in this distinction; however, it is not readily available in many resource-limited developing countries. Aberrant immunoexpression of enhancer of zeste homolog 2 (EZH2), a transcriptional repressor involved in cancer progression, is observed widely in various malignancy. In this study, we evaluate the diagnostic value of EZH2 as a single reliable immunomarker for malignancy in effusion samples. <b><i>Methods:<\/i><\/b> A total of 108 pleural, peritoneal, and pericardial effusions\/washings diagnosed as unequivocally reactive (<i>n<\/i> = 41) and metastatic carcinoma (<i>n<\/i> = 67) by cytomorphology over 18 months were reviewed. Among the metastatic carcinoma cases, 54 were adenocarcinoma and others were squamous cell carcinoma (<i>n<\/i> = 1), carcinosarcoma (<i>n<\/i> = 1), and carcinoma of undefined histological subtypes (<i>n<\/i> = 11). Cell block sections were immunostained by EZH2 (Cell Marque, USA). The percentages of EZH2-immunolabeled cells over the total cells of interest were calculated. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off score to define EZH2 immunopositivity. <b><i>Results:<\/i><\/b> A threshold of 8% EZH2-immunolabeled cells allows distinction between malignant and reactive mesothelial cells, with 95.5% sensitivity, 100% specificity, 100% positive predictive value, and 93.2% negative predictive value (<i>p<\/i> &#x3c; 0.0001). The area under the curve was 0.988. <b><i>Conclusion:<\/i><\/b> EZH2 is a promising diagnostic biomarker for malignancy in effusion cytology which is inexpensive yet trustworthy and could potentially be used routinely in countries under considerable economic constraints.<\/jats:p>","DOI":"10.1159\/000501406","type":"journal-article","created":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T21:00:31Z","timestamp":1564174831000},"page":"248-255","source":"Crossref","is-referenced-by-count":12,"title":["Diagnostic Value of the EZH2 Immunomarker in Malignant Effusion Cytology"],"prefix":"10.1159","volume":"64","author":[{"given":"Piao\u00a0Piao","family":"Ang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geok\u00a0Chin","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norain","family":"Karim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin\u00a0Ping","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2019,7,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2016-0509-CP"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002\/dc.20938"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0339(199808)19:2<131::AID-DC14>3.0.CO;2-G"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0339(199906)20:6<350::AID-DC5>3.0.CO;2-7"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13991"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.9044"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1159\/000377697"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.mrfmmm.2008.07.010"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-10-2156"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/bgq150"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605333"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0463.2009.02579.x"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1002\/dc.22999"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23653"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1111\/his.13123"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.6612"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0199715"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3390\/cancers10040108"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.166.10.5925"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2017\/24339.9888"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.07.139"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.4103\/1742-6413.83233"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1002\/dc.20986"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1309\/PJ7H-A52V-M3XB-V94Y"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0107741"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP0B3YJBXWXJII"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1002\/dc.21006"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1699-0463.1989.tb00475.x"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2559.2001.01157.x"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.40.11.1298"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21392"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-007-0448-x"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23476"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.4103\/0377-4929.85075"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010225)93:1<68::AID-CNCR9009>3.0.CO;2-F"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPU0FION3RKKFO"}],"container-title":["Acta 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