Ishikawa O, Ohhigashi H, Sasaki Y, Imaoka S, Iwanaga T, Wada A, Ishiguro S, Tateishi R, Kishigami Y, Sone H
Department of Surgery, Center for Adult Diseases, Osaka, Japan.
Acta Cytol. 1988 Jul-Aug;32(4):475-81.
Intraoperative cytology was performed for 48 patients with polypoid lesions (36 benign and 12 malignant) of the gallbladder. The cytologic samples consisted of pure bile from 48 patients and diluted bile collected by saline irrigation from 29 patients. Pure bile gave 32 correct diagnoses (67%) and 14 diagnoses of inadequate material (29%), which contained few nondegenerated cells and made microscopic diagnosis unreliable. Inadequate material was frequently obtained in cases of cholesterol polyp (45%), tubular or papillary adenomatous carcinoma (50%) and polypoid carcinoma (17%), but not in cases of inflammatory polyp (0%). On the other hand, cytologic study of bile samples obtained by saline irrigation showed no inadequate material and only one false negative, from a case in which the cancerous focus was mostly covered with nonneoplastic epithelium. These results imply that saline irrigation succeeded in collecting many nondegenerated cells newly exfoliated from the wall of lesions and the technique is useful in the intraoperative cytologic study of polypoid gallbladder lesions.
对48例胆囊息肉样病变患者（36例良性，12例恶性）进行了术中细胞学检查。细胞学样本包括48例患者的纯胆汁以及29例患者通过生理盐水冲洗收集的稀释胆汁。纯胆汁给出了32例正确诊断（67%）和14例取材不足诊断（29%），取材不足的样本中未退化细胞很少，使得显微镜诊断不可靠。在胆固醇息肉（45%）、管状或乳头状腺癌（50%）和息肉样癌（17%）病例中经常获得取材不足的样本，但在炎性息肉病例中未出现（0%）。另一方面，对通过生理盐水冲洗获得的胆汁样本进行的细胞学研究显示没有取材不足的样本，仅有一例假阴性，该病例中癌灶大部分被非肿瘤性上皮覆盖。这些结果表明，生理盐水冲洗成功收集到了许多从病变壁上新脱落的未退化细胞，该技术在胆囊息肉样病变的术中细胞学检查中是有用的。
