Ito K, Inoue Y, Obata K, Noda K
Department of Obstetrics and Gynecology, Kinki University School of Medicine, Osaka, Japan.
Tohoku J Exp Med. 1992 Mar;166(3):387-94. doi: 10.1620/tjem.166.387.
Peritoneal cytology is accepted as part of the evaluation for patients undergoing laparotomy for a suspected or proven gynecologic malignancy. The study subjects were 83 patients with endometrial carcinoma. We investigated the significance of peritoneal cytology in endometrial carcinoma. Cytological positive results were observed in 11 (23%) of the 48 T1 cases, 9 (50%) of the 18 T2 cases and 4 (50%) of the 8 T3 cases. Cytological positive rates by histological differentiations were 14 (28%) for 50 G1 cases, 4 (36%) for 11 G2 cases and 6 (46%) for 13 G3 cases. Cytological positive results were found in 11 (28%) of 39 cases of less than 1/3 of intramuscular infiltration and 13 (37%) of 35 cases of 1/3 or more infiltration. Five (56%) of 9 metastasis cases and 17 (29%) of 59 nonmetastasis cases were found positive cytologically. An analysis of the data indicated that the influence of positive peritoneal cytology on recurrence superceded that of other known risk factors, such as grade, myometrial invasion, extrauterine disease, and lymph node metastasis. The patients with normal cytological findings at laparotomy tend to have a significantly (p less than 0.01) better prognosis than similar patients with abnormal cytological findings.
腹膜细胞学检查被公认为是对疑似或确诊为妇科恶性肿瘤而接受剖腹手术患者评估的一部分。研究对象为83例子宫内膜癌患者。我们研究了腹膜细胞学检查在子宫内膜癌中的意义。在48例T1期病例中，有11例（23%）细胞学检查结果呈阳性；在18例T2期病例中，有9例（50%）呈阳性；在8例T3期病例中，有4例（50%）呈阳性。根据组织学分化情况，50例G1级病例中有14例（28%）细胞学检查结果呈阳性，11例G2级病例中有4例（36%）呈阳性，13例G3级病例中有6例（46%）呈阳性。在肌层浸润小于1/3的39例病例中，有11例（28%）细胞学检查结果呈阳性；在肌层浸润1/3及以上的35例病例中，有13例（37%）呈阳性。9例转移病例中有5例（56%）细胞学检查呈阳性，59例非转移病例中有17例（29%）呈阳性。数据分析表明，腹膜细胞学检查结果呈阳性对复发的影响超过了其他已知风险因素，如分级、肌层浸润、子宫外病变和淋巴结转移。剖腹手术时细胞学检查结果正常的患者预后往往明显（p<0.01）好于细胞学检查结果异常的类似患者。
