Exfoliative Cytology in the Diagnosis of Stomach Cancer

Abstract

Exfoliative cytology was performed in 1866 patients during the 8 years of this study. Of these, 1584 had proved benign or normal stomachs. False positive reports were issued in only 4 cases. The positive report is, therefore, highly significant, tantamount to the diagnosis of cancer. Cytology was positive in 81% of 282 patients with proved malignancy. The accuracy, however, varied with the histological type of tumor, being 86% with adenocarcinoma and 39% with non-epithelial tumors. The accuracy also varied with the location of the tumor. Cytology was positive in 93% of malignant lesions of the cardia; in 70% of malignant gastric ulcers of the body; and in 80% of antral malignancies. Cytology was uniquely accurate in evaluating the operated stomach for recurrence, with malignant cells being recovered in all 18 cases with proved recurrence in the gastric remnant or at the anastomotic site.