Gozalan Ugur, Yasti Ahmet Cinar, Yuksek Yunus Nadi, Reis Erhan, Kama Nuri Aydin
4th Department of Surgery, Ankara Numune Education and Research Hospital, 06500, Ankara, Turkey.
Am J Surg. 2007 Jun;193(6):672-5. doi: 10.1016/j.amjsurg.2006.10.020.
The value of peritoneal washing cytology on prognosis is not clear yet. The aims of our prospective study were to consider the incidence and prognostic value of peritoneal cytology.
From 1996 to 2003, washing cytology was performed in 88 patients who underwent surgery for colorectal cancer. Before exploration and manipulation of the tumor, each of the peritoneal cavities next to the tumor site, subhepatic and rectovesical recesses, were irrigated with 50 mL saline, and then the aspirates were taken for cytological evaluation.
Thirteen (14.7%) of 88 patients had positive cytology. Although necrosis, depth of invasion, differentiation of the tumor, macroscopic peritoneal dissemination, and ascites were correlated with positive cytology; multivariate analyses revealed the depth of invasion, presence of necrosis, and differentiation of the tumor as the factors affecting the cytology. The disease-free and overall-survival times in patients with positive and negative peritoneal washing cytology were 56.36, 61.40 and 52.08, 63.94 months, respectively (P > .05).
The presence of free malignant cells in the peritoneal cavities of patients who underwent curative resection for colorectal cancer provides no further prognostic value over the current staging systems.
腹膜冲洗细胞学检查对预后的价值尚不清楚。我们这项前瞻性研究的目的是探讨腹膜细胞学检查的发生率及其预后价值。
1996年至2003年期间，对88例行结直肠癌手术的患者进行了冲洗细胞学检查。在探查和处理肿瘤之前，用50毫升生理盐水冲洗肿瘤部位旁、肝下和直肠膀胱陷凹处的每个腹膜腔，然后抽取冲洗液进行细胞学评估。
88例患者中有13例（14.7%）细胞学检查呈阳性。虽然坏死、浸润深度、肿瘤分化程度、肉眼可见的腹膜播散及腹水与细胞学阳性相关；但多因素分析显示，浸润深度、坏死的存在及肿瘤分化程度是影响细胞学检查结果的因素。腹膜冲洗细胞学检查阳性和阴性患者的无病生存期和总生存期分别为56.36、61.40个月和52.08、63.94个月（P>.05）。
接受结直肠癌根治性切除的患者腹膜腔内存在游离恶性细胞，相对于目前的分期系统，并未提供更多的预后价值。
