Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China.
Cell Transplant. 2019 Nov;28(11):1384-1389. doi: 10.1177/0963689719864318. Epub 2019 Aug 1.
The cytology of peritoneal washing fluids for gastric cancer is the most basic method for judging peritoneal micrometastasis. However, the clinical value of this method is not clear at present. A retrospective analysis was performed on 277 patients with pathologically proven and surgically treated gastric cancer. The peritoneal washing fluids were collected after opening the abdomen and before the operation, and were sent to the cytology laboratory for screening of occult cancer cells in the collected washing fluids. The number of cases diagnosed as cancer cells, reactive mesothelial cells, serosal balls, and traumatic mesothelial cells were 42, 18, 27, and 190, respectively. Typical adenocarcinoma cell nests were found in eight of 10 T4b samples, whereas 34 cases of cancer cells in T3 and T4a showed that these cell nests usually contained mesothelial cells, and the three-dimensional stereoscopic sense of the nests was not obvious. In the specific subcellular morphological changes of both reactive mesothelial cells and serosal balls, the changes of both the contour of nuclear membrane and the polarity of cell alignment were present only in stage T3 and T4a. The presence or absence of mesothelial cells in the nests of cancer cells and the changes of the contour of nuclear membrane and of the polarity of cell alignment in reactive mesothelial cells or serosal balls may help us to predict the depth of invasion of cancer cells.
腹腔冲洗液细胞学检查是判断胃癌腹膜微转移最基本的方法，但目前该方法的临床价值尚不清楚。对 277 例经病理证实并接受手术治疗的胃癌患者进行回顾性分析，在剖腹探查及手术前采集腹腔冲洗液，送细胞学实验室筛选收集的冲洗液中是否存在隐匿性癌细胞。诊断为癌细胞、反应性间皮细胞、浆膜球和创伤性间皮细胞的病例数分别为 42、18、27 和 190。10 例 T4b 样本中有 8 例发现典型腺癌细胞巢，而在 T3 和 T4a 的 34 例癌细胞中，这些细胞巢通常含有间皮细胞，巢的三维立体感不明显。在反应性间皮细胞和浆膜球的具体亚细胞形态变化中，仅在 T3 和 T4a 期出现核膜轮廓和细胞排列极性的变化。癌细胞巢中是否存在间皮细胞以及反应性间皮细胞或浆膜球中核膜轮廓和细胞排列极性的变化，可能有助于我们预测癌细胞的浸润深度。
