STUDY OF PERITONEAL LAVAGE CYTOLOGY DURING GASTRIC CANCER SURGERY

Abstract

In the appropriate treatment and prediction of prognosis of gastric cancer, it appears important accurately to determine the presence of disseminated peritoneal metastasis before or during surgery. For this purpose, we carried out peritoneal lavage cytology and examined the results clinicopathologically. For lavage cytology, then cavum douglasi was washed with 200ml of physiological saline just after abdominal section, and the washings recovered were subjected to cytodiagnosis. The insidence of positive results for lavage cytology was 36.5% on average, showing a decrease in parallel with cancer progression. Twelve (26.7%) of 46 negative cases in macroscopic disseminated peritoneal metastasis were found to be positive upon lavage cytology. Most of these 12 cases had cancers infiltrating into the serosa and measuring 6cm or more. Histologically, the positive rate was higher in infiltrating-type lesions, but there was no obvious difference by histological type. With regard to the sites of the lesions, the positive rate was higher among whole-circumference lesions and those in the anterior wall. Thus, determination of the clinicopathological features of positive cases in petitoneal lavage cytology, i.e., potential cases of disseminated peritoneal metastasis, seems to be helpful for prophylaxis against dissaminated peritoneal metastasis and forecase of the recurrence.