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[Peritoneal lavage cytology in 66 patients with gastric carcinoma]
Zhao-xu Zheng1, Xing-hua Yuan, Wei-qi Rong
1Department of General Surgical Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Objective:
To evaluate the clinical and prognostic value of peritoneal lavage cytology (PLC) in detecting free cancer cells (FCC).
Methods:
PLC of 66 gastric cancer patients being operated was prospectively analyzed to assess the prognostic significance of positive cytological finding and its relation with serosal invasion, lymph node metastasis and stage classification.
Results:
The overall positive rate of cytology was 36.4% (24/66). These was a closely relation between positive cytology results and serosal invasion (P = 0.025), abdominal lymph node involvement (P < 0.005) and stage classification. Peritoneal recurrence in patients with positive cytological findings was significantly higher than that with negative results (P = 0.006 7).
Conclusion:
Micrometastasis to the abdominal cavity, formed by free cancer cells exfoliated from the tumor, are significantly responsible for peritoneal dissemination. Serosal invasion and metastatic nodes have greater risk for positive cytology and implies poor prognosis. Peritoneal lavage cytology, if practiced in all gastric cancer patients being operated, can predict the operative effect and prognosis, increase the accuracy of clinical stage and provide information for further adjuvant therapy.