Matthes A C, Moreira de Andrade J M, Bighetti S
Department of Obstetrics and Gynecology, University Hospital, Faculty of Medicine, Ribeirâo, Prêto, Brazil.
Gynecol Obstet Invest. 1996;42(4):244-8. doi: 10.1159/000291973.
The major objective of the present study was to determine whether leakage of ovarian cyst cells occurs when the cysts are punctured inside a container with saline. Other subjectives were to determine the sensitivity and specificity of cytology in the differentiation between malignant and benign cysts by comparing cytology data with histology data, and also to determine whether ultrasound can provide consistent evidence for predicting whether the cyst is benign or malignant, thus permitting the selection of patients with benign cysts for puncture rather than surgical exeresis. A cytologic study was carried out on the contents of 62 ovarian cysts diagnosed by ultrasound and clinical examination, and excised from 51 patients submitted to exploratory laparotomy. The cyst was excised and immersed in a container with saline outside the surgical field. The cyst was punctured and its contents aspirated through the wall of the container. Five samples were obtained for cytology: (1) presurgical abdominal wash; (2) saline before cyst puncture; (3) fluid from the punctured cyst; (4) saline after cyst puncture, and (5) postoperative abdominal wash. The materials obtained were submitted to centrifugation and slides of the precipitate were prepared for cytology. A total of 248 slides were studied. Slides of cysts with good cellularity were stained with silver to study the nucleolar organizer regions. Analysis using Kappa statistics showed excellent agreement between the cytologic and histologic diagnoses (p < 0.001). The sensitivity of the cytologic study of the cyst was 75% and the specificity 100%, with a positive predictive value of 100%, a negative predictive value of 92%, and 93% accuracy. The present results led us to conclude that cell leakage into physiological saline occurred after puncture and that cytologic study of cysts valuable in the diagnosis of benign and malignant processes.
本研究的主要目的是确定当卵巢囊肿在装有生理盐水的容器内被穿刺时，囊肿细胞是否会发生渗漏。其他目的是通过将细胞学数据与组织学数据进行比较，确定细胞学在鉴别恶性和良性囊肿方面的敏感性和特异性，并且确定超声是否能够提供一致的证据来预测囊肿是良性还是恶性，从而允许选择良性囊肿患者进行穿刺而非手术切除。对62个经超声和临床检查诊断、并从51例行剖腹探查术的患者身上切除的卵巢囊肿内容物进行了细胞学研究。囊肿在手术野之外被切除并浸入装有生理盐水的容器中。囊肿被穿刺，其内容物通过容器壁吸出。获取了五个样本用于细胞学检查：（1）术前腹腔冲洗液；（2）囊肿穿刺前的生理盐水；（3）穿刺囊肿的液体；（4）囊肿穿刺后的生理盐水，以及（5）术后腹腔冲洗液。所获得的材料进行离心，沉淀物制成载玻片用于细胞学检查。共研究了248张载玻片。细胞丰富的囊肿载玻片用银染色以研究核仁组织区。使用Kappa统计分析显示细胞学诊断和组织学诊断之间具有极好的一致性（p < 0.001）。囊肿细胞学研究的敏感性为75%，特异性为100%，阳性预测值为100%，阴性预测值为92%，准确率为93%。目前的结果使我们得出结论，穿刺后细胞会漏入生理盐水中，并且囊肿的细胞学研究对诊断良性和恶性病变很有价值。
