胃癌根治术中组织印片细胞学检查的评价

目的 探讨印片细胞学检查在胃癌根治术中的快速诊断价值。方法 在52例胃癌根治术的新鲜标本上，分别于近端切缘、远端切缘、瘤组织、近瘤旁组织及部分淋巴结232处印片取材，凉干，行细胞学检查，观察有无瘤细胞。将其结果与常规病理检查结果相对照。结果 瘤组织处假阴性1例无假阳性；切缘处无假阴性，假阳性12例；瘤旁组织假阴性3例，假阳性10例；全组标本敏感性92．8％，特异性85．8％，准确性87．9％。结论 胃癌根治术中印片细胞学检查对判断切缘有无残留病灶有一定价值，尤其是对不具备快速病理检查的基层医院有帮助，但不能完全取代快速病理检查，二者结合更为有利。

Evaluation of cytological examination of impressed specimens in radical gastrectomy for gastric cancer

Objective To determine the clinical value of cytological diagnosis of the impressed specimens in the radical gastrectomy for patients with gastric cancer. Methods During radical gastrectomies for 52 patients with gastric cancer, 232 impressed specimens were taken from the tumor tissues,paratumor tissues, proximal and distal incision margin,and partial lymph nodes respectively, to detect if there was tumor cells by cytological examination and compared with the pathology. Results In the tumor tissues,there were no pseudo positive specimen,and the pseudo negative specimen occurred in 1.In the incision margin,there was no pseudo negative specimen,while 12 pseudo positive specimens were found.In the paratumor tissues,there were 3 pseudo negative and 10 pseudo positive specimens.In all specimens,the sensibility was 92.8%; specificity was 85.8%; accuracy rate was 87.9%. Conclusions Cytological examination of the impressed specimens in radical gastrectomy is helpful in detecting residue tumor tissue in the incision margin, especially in hospitals without rapid pathologic examination.If cytological examination is combined with rapid pathological examination,the results will be better.