刷片细胞学检查在胃癌及食管癌诊断中的价值

背景 ]探讨刷片细胞学检查在胃及食管癌诊断中的价值 .病例报告 ]用刷片细胞学检查诊断为胃、食管癌的 2 13例与病理活体检查结果进行比较 .结果 ]刷片细胞学检查与病理诊断完全符合 16 8例 (78 9% ) ,基本符合 19例 (8 9% ) ,总的符合率为 87 8% .不符合的为 2 6例(12 2 % ) ,其中刷片细胞学检查假阳性 2 2例 (10 3% ) ,病理诊断为胃溃疡 10例 ,萎缩性胃炎 5例 ,浅表性胃炎伴糜烂 2例 ,不典型增生 2例 ,单纯增生 3例 .刷片细胞学检查阳性而病理活体检查假阴性 4例 ,术后证实为癌症 .讨论 ]刷片细胞学检查总的符合率接近活体检查的阳性率 .鉴别胃溃疡的脱落的变性、退化的上皮细胞 ,萎缩性胃炎时肠化的上皮细胞及不典型增生细胞是减少刷片细胞学检查假阳性的关键 .刷片细胞学检查阳性 ,活体检查阴性时不能只强调活体检查结果而轻易排除癌的诊断 .

Diagnostic value of brush cytology in gastric and esophageal carcinoma

BACKGROUND To investigate the diagnostic value of gastric and esophageal carcinomas by brush cytology. CASE REPORT 213 cases of gastric and esophageal carcinomas diagnosed by brush cytology were compared with that diagnosed by biopsy. Out of 213 cases of gastric and esophageal carcinoma, 168(78 9%) cases diagnosed by brush cytology and biopsy were completely coincidence, 19(8 9%) cases were basically coincidence, and total coincidence rate was 87 8%. 26(12 2%) cases had no coincidence, in which there were 22(10 3%) cases of pseudo positive, 10 cases of gastric ulcer, 5 cases of atrophic gastritis, 2 cases of superficial gastritis with erosion, 2 cases of dysplasia and 3 cases of simple hyperplasia. 4 cases were positive by brush cytology, but negative by biopsy and were demonstrated as cancers after operation. DISCUSSION Total coincidence rate of diagnosis by brush cytology approaches positive rate by biopsy in the diagnosis of gastric and esophageal carcinoma. In differentiating gastric ulcer, it is the key for reducing the pseudo positive by brush cytology that the cast off degenerative and regressive epithelial cells, epithelial cells of intestinal metaplasia in atrophic gastritis and dysplesia cells. When the results of brush cytology are negative, the results of biopsy could not be only emphasized and diagnosis of cancer could not be readily excluded.