Iwagami Yoshifumi, Eguchi Hidetoshi, Wada Hiroshi, Tomimaru Yoshito, Hama Naoki, Kawamoto Koichi, Kobayashi Shogo, Mori Masaki, Doki Yuichiro, Nagano Hiroaki
Department of Surgery, Graduate School of Medicine, Osaka University, Yamadaoka 2-2 (E2), Suita, Osaka, 565-0871, Japan,
Surg Today. 2015 Apr;45(4):444-50. doi: 10.1007/s00595-014-0964-7. Epub 2014 Jul 1.
The aim of this study was to determine the utility of the peritoneal lavage cytology findings in predicting the clinical outcomes of resectable left-sided pancreatic cancer.
Peritoneal lavage samples were collected from 39 consecutive patients who underwent surgery for left-sided pancreatic cancer between January 2000 and December 2010. We analyzed the correlations between the peritoneal lavage cytology findings and the clinical outcomes.
Five patients (12.8 %) had malignant cells in the cytology samples (positive cytology). This occurred more frequently in patients with vascular invasion (P = 0.008). Positive cytology was significantly associated with lower overall (P = 0.0007) and recurrent-free (P < 0.0001) survival rates. Positive cytology was an independent prognostic factor for recurrence (P = 0.022); it was closely associated with local recurrence, peritoneal recurrence and distant metastasis.
Surgeons should carefully consider the intraoperative diagnosis of peritoneal lavage cytology in patients with resectable left-sided pancreatic cancers, because patients with positive cytology are likely to experience recurrence.
本研究旨在确定腹腔灌洗细胞学检查结果在预测可切除左侧胰腺癌临床结局方面的效用。
收集了2000年1月至2010年12月期间连续39例行左侧胰腺癌手术患者的腹腔灌洗样本。我们分析了腹腔灌洗细胞学检查结果与临床结局之间的相关性。
5例患者(12.8%)的细胞学样本中有恶性细胞(细胞学阳性)。在有血管侵犯的患者中更常出现这种情况(P = 0.008)。细胞学阳性与较低的总生存率(P = 0.0007)和无复发生存率(P < 0.0001)显著相关。细胞学阳性是复发的独立预后因素(P = 0.022);它与局部复发、腹腔复发和远处转移密切相关。
对于可切除左侧胰腺癌患者,外科医生应仔细考虑术中腹腔灌洗细胞学诊断,因为细胞学阳性的患者可能会出现复发。