الفهرس 
Anatomy of StomachOnly 14 pages are availabe for public view
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Abstract
The aim of this study the incidence of positive gastric cancer
peritoneal lavage pre- and post- resection in the same patients and to be
followed lately for possible local recurrence or distant metastasis.
It was a prospective study, conducted at general surgery department
in Menoufia University hospitals, included 20 patients with gastric cancer
indicated for surgery. Intra-operative peritoneal lavage pre- and post-tumor
resection was done to detect intra-peritoneal cancer cells (IPCC) by
conventional cytology. The duration of the study was 2 years.
Pre- and post-operative samples were collected in 2 labeled syringes
that were sent to the Department of Pathology for processing. The specimen
was centrifuged (8,500 rotations/min) for ten minutes. The material was
smeared on slides, fixed with cytospray, stained with hematoxylin and eosin
stain (H&E), and examined under a light microscope by the same
pathologist.
The smears were classified according to their cytologic features, as
follows:
1) Positive for tumor cells: that showed malignant features.
2) Negative for malignant cells.
Cytological interpretation: All slides were reviewed and diagnosed
by the same pathologist who is specialized in gastrointestinal oncology.
Fluids were cytologically diagnosed as “negative for malignancy”, or
“positive for malignancy”.
The results regarding included twenty patients was as following:
Eight patients (40%) were males and 12 (60%) were females, and the
median age of the patients was 52.5 years. Regarding surgical procedure, 13
Summary
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patients had open technique (65%) and 7 patients had laparoscopic approach
(35%). Pre-resection cytology was positive in 2 patients (10%) and negative
in 18 patients (90%). Post-resection cytology was positive in 3 patients
(15%) and negative in 17 patients (85%). According to T status, 1 patient
(5%) was pT1, 6 (30%) were pT2, 10 (50%) were pT3 and 3 (15%) were
pT4. Regarding lymph nodes status: 6 patients were associated with
Negative lymph nodes (30%) and 14 patients showed positive lymph nodes
(70%). Pathological examination revealed that adenocarcinoma had been
encountered in 16 (80%) patients, in comparison to 4 patients (20%) who
had Signet ring cell carcinoma.
Patients were divided into 2 groups according to peritoneal lavage
fluid conventional cytology performed immediately after opening abdomen
and before manipulation or tumor resection.
group I with positive cytology from start (positive pre-resection
cytology) (2 patients).
group II with negative cytology (negative pre-resection cytology) (18
patients).
Positive pre-resection cytology was significantly prevalent in cases
with positive lymph node metastases (P <0.05). However, T stage did not
show statistically significant difference between the two groups (P = 1.00),
also there were no significant difference regarding pathological type of the
tumor between adenocarcinoma and signet ring cell carcinoma types (P =
0.37). Regarding Demographic criteria, operative procedure (open or
laparoscopic), there was no statistically significant difference between the
two groups.
Summary
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All the patients in group I had positive post-resection cytology. Group
II (18 patients) were further subdivided into two groups according to the
status of post-resection cytology. group II a (1 patient) with positive postresection
cytology and group II b (17 patients) with negative cytology.
Gender did not show significant difference between the two groups.
Comparing both groups regarding nodal status, showed significant
prevalence of positive post-resection cytology in cases of positive nodal
metastases (P= 0.02). Although there was more prevalence of higher (T)
status in group II A with (T4) more than (T1 and T2), compared with Group
II B, this difference did not reach the statistical power of significance
(P=0.264). There was no statistically significant difference between the two
groups regarding type of tumor (adenocarcinoma versus signet ring cell
carcinoma) (P=1.0) or operative procedures (open versus laparoscopic).