胃癌根治术中组织印片细胞学诊断的意义

目的探讨印片细胞学检查在胃癌术中的应用价值。方法在34例胃癌根治术的新鲜标本上,分别在癌灶、近癌旁组织近切缘、远切缘及部分淋巴结145处印片取材,凉干,瑞氏染色,行细胞学检查,观察有无癌细胞,其结果与常规病理检查结果相对照。结果癌组织处假阳性、假阴性各1例,准确率94.1%;切缘处无假阴性、假阳性14例;癌旁组织假阴性3例,假阳性12例;全组标本示假阳性较高;敏感性90.5%,特异性72.8%,准确率77.9%。结论胃癌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确有帮助,但不能完全取代快速病理检查,二者结合更为有利。

Evaluation of cytological diagnosis of impressed specimen for radical gastrotectomy of gastric cancer

Objective To approach the clinical value of cytological diagnosis of the impressed specimen in the radical gastrotectomy of the patients with gastric cancer.Methods From the gastric samples of34patients with gastric cancer,authors gained145impressed specimen from the tumour and adjacent tissues to tumour,proximal and distal incisal margin and partial lymph nodes respectively,and through Ray' staining and cytological examination detected whether there was tumour cell there,and compared the results with the routine pathology.Results Pseudopositive and pseudonegative result each was one case in the cancer tissues respectively,Accuracy was94.1%.There were no pseudonegative cases,but 14pseudopositive cases in incisal margin;there were3pseudonegative cases and12pseudopositive cases in the adjacent tissues.In all specimens sensitivity was90.5%,specifity was72.8%,accuracy was77.9%.Conclusion Cytological diagnosis of the impressed specimen for radical gastrotectomy is helpful to detecingt residual cancer tissue in incisal margin,especially in the hospital without rapid pathologic examination.If combined with rapid pathologic examination it's better.