胃癌腹腔脱落细胞检查及临床意义

腹膜转移是胃癌常见的转移形式。为在肉眼可见转移前发现亚临床的转移现象,自1981年3月至1982年4月,我们共对胃癌病人142例进行了腹腔脱落细胞检查及临床随诊,发现有腹腔脱落细胞阳性者76例(53.5％)。5年随诊结果发现,腹腔脱落细胞阳性者无一例生存>3年;而腹腔脱落细胞阴性的66例中生存5年者有11例。可见,腹腔脱落细胞检查,对胃癌的诊断,治疗和预后判断有一定价值。

THE SIGNIFICANCE OF PERITONEAL EXFOLIATIVE CYTOLOGY IN GASTRIC CANCER

Exfoliated cells in abdominal cavity were studied in 142 patients with gastric cancer. The cells were mainly obtained by irrigation with normal saline during operation. In this series, 53.5%(76/142) of the patients have malignant exfoliative cells. The relationships between the localization and the pathological types of cancer and the positive rate of the exfoliative cells in the abdominal cavity were discussed. No significant differences were found with regard to the TNM staging of the gastric cancer, the positive rate of stage I was 4/5, while those of the stage II,III,IV were 36%, 42.6% and 66.2%, respectively. The five-year follow-up study showed that in the positive exfoliative group, none lived more than 3 years, including 4 cases of TNM stage I, 9 cases of stage II and 63 cases with advanced cancer. However, in the 66 cases with negative cytology, 1 case of stage I patient was alived more than 7 years after operation, and in the 26 cases of stage II, 10 survived more than 5 years. This method is recommanded to detect the early metastasis of gastric cancer in the abdominal cavity. It may be useful in planning a reasonable management for the patient and may give a better understanding about the prognosis.