Suzuki T, Ochiai T, Hayashi H, Nakajima K, Yasumoto A, Hishikawa E, Shimada H, Horiuchi F, Ohki S, Isono K
Department of Surgery II, Chiba University School of Medicine, Japan.
Surg Today. 1999;29(2):111-5. doi: 10.1007/BF02482234.
Although peritoneal lavage cytology is widely performed during surgery for gastric cancer and the results have been reported to be one of the accurate prognostic factors, the cancer stage is determined independent of the results of lavage cytology according to the First English Edition of Japanese Classification of Gastric Carcinoma. In this study we demonstrated the validity of lavage cytology for accurately staging gastric cancer. Between 1988 and 1996, peritoneal lavage cytology was performed in 347 patients with resectable gastric cancer. Among them, cytology was positive in 29 cases (8.4%). The survival rate of the cytology-positive patients in each stage was worse than that of all patients in the same stage. The prognosis of patients with positive cytology findings and serosa-exposed gastric cancer was significantly worse than that of negative cytology findings and serosa-exposed gastric cancer, and similar to that of negative cytology findings and serosa-infiltrating gastric cancer. Our data indicated that positive cytology findings thus indicated a poor prognosis, and the prognostic difference between positive and negative cytology findings was approximately a one-stage difference in the Japanese stage grouping. Based on our findings, the results of peritoneal lavage cytology should thus be included in the factors for staging gastric cancer.
尽管在胃癌手术期间广泛进行腹腔灌洗细胞学检查，且其结果据报道是准确的预后因素之一，但根据日本胃癌分类第一英文版，癌症分期是独立于灌洗细胞学检查结果来确定的。在本研究中，我们证明了灌洗细胞学检查对准确分期胃癌的有效性。1988年至1996年期间，对347例可切除胃癌患者进行了腹腔灌洗细胞学检查。其中，细胞学检查阳性的有29例（8.4%）。各期细胞学检查阳性患者的生存率均低于同期所有患者。细胞学检查结果阳性且浆膜暴露的胃癌患者的预后明显差于细胞学检查结果阴性且浆膜暴露的胃癌患者，且与细胞学检查结果阴性且浆膜浸润的胃癌患者相似。我们的数据表明，细胞学检查结果阳性表明预后不良，在日本分期分组中，细胞学检查结果阳性与阴性之间的预后差异约为一个分期的差异。基于我们的研究结果，腹腔灌洗细胞学检查结果因此应纳入胃癌分期的因素中。
