胃癌患者应用诊断性腹腔灌洗术进行细胞学检测的意义

A prospective clinical trial of diagnostic peritoneal lavage for peritoneal cytology in patients with gastric cancer

目的:观察在胃癌患者中应用经皮诊断性腹腔灌洗术(diagnostic peritoneal lavage,DPL)的安全性及有效性,明确胃癌患者是否可用诊断性腹腔灌洗术进行细胞学检测.方法:入组的27例胃癌患者,在进行诊断性腹腔镜检查(diagnostic laparoscopy,DL)术前,先进行DPL.行腹腔穿刺后将生理盐水通过医用经皮导管灌入患者腹腔内,收集腹腔灌洗液用于进行细胞学检测(DPL-Cyt).经腹腔镜下向腹腔内冲入生理盐水,收集镜下冲洗液进行细胞学检测(DPL-Cyt).结果:在27例患者中,施行DPL的成功率为81.5%(22/27).在成功施行DPL的22例患者中,有12例患者细胞学阳性,其阳性率为54.5%.与DL细胞学的阳性率是一致的.结论:胃癌患者应用DPL进行细胞学检测是一种安全有效的方法,在胃癌的诊断分期中有重要指导意义.

AIM： To assess the safety and feasibility of diag- nostic peritoneal lavage （DPL） in gastric cancer patients and determine whether DPL can be used to assess peritoneal cytology in patients with gastric cancer. METHODS： Patients with gastric adenocarci- noma were prospectively enrolled to undergo DPL prior to diagnostic laparoscopy （DL）. Saline was instilled through a percutaneous catheter and fluid was collected for cytology （DPL-cyt）. Washings obtained during DL were used as con- trols （DL-cyt）. RESULTS： DPL was successful in 22 of 27 pa- tients （81.5%）. Among the 22 cases of successful DPL, 12 had positive cytology （54.5%）, Positive DPL-cyt specimens were consistent with DL-cyt specimens in 12/12 cases （specificity = 100%）.CONCLUSION： DPL is a safe method for detect- ing positive cytology in patients with gastric cancer.