Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Gynecol Oncol. 2020 May;157(2):398-404. doi: 10.1016/j.ygyno.2020.02.004. Epub 2020 Feb 13.
To compare the efficacy of ascitic fluid cell block (ACB) with that of core needle biopsy (CNB) or the CA125/CEA ratio in diagnosing primary tubo-ovarian cancer in female patients with peritoneal carcinomatosis (PC) with ascites.
This retrospective study examined female patients with PC with ascites who had available results for ACB, peritoneal tumor CNB, and the CA125/CEA ratio. Several measures of the accuracy of ACB and the CA125/CEA ratio were calculated and compared, with CNB as the reference standard.
Of 81 patients with available results, 57 were clinically diagnosed with primary tubo-ovarian cancer. Overall, 52, 47, and 64 patients were diagnosed via CNB, ACB, and CA125/CEA ratio > 25, respectively. CNB and ACB identified the cancer origin in 91.4% and 82.7% cases, respectively. The concordance ratio of the immunohistochemical findings between ACB and CNB was 93.6%. Two patients with inconclusive CNB results were diagnosed with primary tubo-ovarian cancer via ACB. The sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio were 86.5%, 93.1%, 95.7%, 79.4%, and 12.5, respectively, for ACB and 94.2%, 48.3%, 76.6%, 82.4%, and 1.82, respectively, for CA125/CEA ratio > 25.
ACB is not inferior to CNB in diagnosing primary tubo-ovarian cancer; the two methods complement each other. ACB can substitute CNB in diagnosing primary tubo-ovarian cancer in selected PC patients. ACB is superior to a CA125/CEA ratio of >25 in diagnosing primary tubo-ovarian cancer. ACB is effective, reliable, and convenient for diagnosing primary tubo-ovarian cancer in PC patients with ascites.
比较腹水细胞块（ACB）与核心针活检（CNB）或 CA125/CEA 比值在诊断伴有腹水的腹膜癌性疾病（PC）女性患者原发性卵巢-输卵管癌中的疗效。
本回顾性研究纳入了伴有腹水且 ACB、腹膜肿瘤 CNB 和 CA125/CEA 比值结果可用的 PC 伴腹水女性患者。计算并比较了几种 ACB 和 CA125/CEA 比值准确性的衡量指标，并以 CNB 作为参考标准。
在 81 例有结果的患者中，57 例临床诊断为原发性卵巢-输卵管癌。总体而言，CNB、ACB 和 CA125/CEA 比值>25 分别诊断出 52、47 和 64 例癌症。CNB 和 ACB 分别在 91.4%和 82.7%的病例中确定了癌症起源。ACB 和 CNB 的免疫组化结果一致性比率为 93.6%。2 例 CNB 结果不确定的患者通过 ACB 诊断为原发性卵巢-输卵管癌。ACB 的敏感性、特异性、阳性预测值、阴性预测值和阳性似然比分别为 86.5%、93.1%、95.7%、79.4%和 12.5，CA125/CEA 比值>25 的分别为 94.2%、48.3%、76.6%、82.4%和 1.82。
ACB 在诊断原发性卵巢-输卵管癌方面并不逊于 CNB，两种方法相辅相成。ACB 可替代 CNB 用于诊断特定 PC 患者的原发性卵巢-输卵管癌。ACB 在诊断原发性卵巢-输卵管癌方面优于 CA125/CEA 比值>25。ACB 对于诊断伴有腹水的 PC 患者的原发性卵巢-输卵管癌是有效、可靠和方便的。
