Chambers L A, Clark W E
Acta Cytol. 1986 Mar-Apr;30(2):110-4.
Cytologic reports were compared to final diagnoses for 1,157 gastroesophageal samples from an eight-year period in order to evaluate the diagnostic accuracy of endoscopic cytology and to determine the significance of a "suspicious" cytologic report. In the subgroup of patients with adenocarcinoma evaluated by paired endoscopic biopsy and cytology, the relative and combined sensitivities of the sampling methods were studied. Cytologic examination was reported as positive or suspicious in 85% of 229 cases of malignancy. There were three false-positive diagnoses of squamous-cell carcinoma of the esophagus, representing 0.3% of all submitted samples. Suspicious cytologic reports were issued in 5% of all cases. The majority (63%) of patients with a suspicious cytologic report had a final diagnosis of malignancy, with gastric adenocarcinoma present in almost half of the cases. Adenocarcinoma was diagnosed in 168 of the patients. Combined endoscopic biopsy and cytology was more sensitive (96%) than biopsy alone (90%) in making the initial diagnosis. Cytology may be of particular value in the diagnosis of gastroesophageal malignancy when the lesions are small and superficial or where stricture precludes adequate biopsy. Regardless of the biopsy findings, patients with "suspicious" cytologic reports require careful reevaluation since a high percentage of those cases in our series were subsequently verified as having malignancy.
为评估内镜细胞学检查的诊断准确性并确定“可疑”细胞学报告的意义，我们将8年期间1157份胃食管样本的细胞学报告与最终诊断结果进行了比较。在通过配对内镜活检和细胞学检查评估的腺癌患者亚组中，研究了采样方法的相对敏感性和联合敏感性。在229例恶性肿瘤病例中，85%的细胞学检查报告为阳性或可疑。有3例假阳性诊断为食管鳞状细胞癌，占所有送检样本的0.3%。所有病例中有5%出具了可疑细胞学报告。大多数（63%）有可疑细胞学报告的患者最终诊断为恶性肿瘤，其中近一半病例为胃腺癌。168例患者被诊断为腺癌。在内镜活检和细胞学联合检查中，初步诊断的敏感性（96%）高于单纯活检（90%）。当病变较小且表浅或存在狭窄而无法进行充分活检时，细胞学检查在胃食管恶性肿瘤的诊断中可能具有特殊价值。无论活检结果如何，有“可疑”细胞学报告的患者都需要仔细重新评估，因为在我们的系列病例中，这些病例中有很大比例随后被证实患有恶性肿瘤。
