- 期刊
食道癌的擦刷細胞學檢查
Endoscopic Brush Cytology in the Diagnosis of Cancer of the Esophagus
摘要
本文以馬偕醫院在25個月間，接受胃鏡檢查，並同時作生檢與食道擦刷細胞檢患者共39例爲對象，來分析食道癌的細胞檢與生檢診斷之一致性及其敏感度(sensitivity)。 在我們的統計中，25例最後證實爲癌症患者，有12例接受手術，13例未接受手術。其中9例細胞檢、胃鏡生檢和術後大體生檢皆為陽性，3例胃鏡生檢和術後大體生檢為陽性，7 例細胞檢表胃鏡生檢爲陽性，4例單獨胃鏡生檢為陽性，2例單獨細胞檢為陽性。 本研究裹，有18例細胞學檢查為陽性，其敏感度為72%；有22例生檢為陽性，其敏感度為88%；細胞檢或生檢二者之一為陽性者有24例，其敏感度為96%。在16例細胞檢和生檢同為陽性患者中，有13例組織類型相同，二者一致性爲81.2%。 有許多食道病變，從內視鏡所看到的大體外觀，難以區別重度食道炎或浸潤性癌；而所作的食道切片檢查，或許也只能看到伴隨著癌瘤的炎性反應而已。所有此類病變，都必須仔細作細胞學檢查。
關鍵字
無資料並列摘要
Direct-vision endoscopic biopsies and brush cytologies were performed on 39 patients during a 25-month period in Mackay Memorial Hospital. The correlated cyto-pathologic typing and its sensitivity rate in the diagnosis of esophageal cancer were studies. For our study we collected twenty five cases of proven malignancy. Twelve patients received operation; thirteen did not. Nine cases had positive findings in cytology endoscopic biopsy and surgical specimen; three cases had positive finding in endoscopic biopsy and surgical specimen; seven had positive finding in cytology and endoscopic biopsy; four had positive biopsy specimen; and two had positive cytology. In our cytological examination, malignant cells were diagnosed in 18 of 25 with: finally proven malignancy. The sensitivity rate of the endoscopic brush cytology was 72%. It is far less than 22 of the 25 cases (88%) diagnosed by pathology. However, there were none malignant cell reported by pathology in 2 of 18 cases with cytological proven malignancy. The overall sensitivity rate of the cytology or pathology was 96%. In the remaining 16 cases with both cytology and pathology proven malignancy, 13 had been diagnosed as the same cell type, the same correlated typing rate of cyto-pathology was 81.2%. It may be impossible to differentiate severe esophagitis from infiltrative cancer by the gross appearance at endoscopy. Biopsies from patients with cancer may show only the associated inflammation. Thus, all such lesion should have careful cytological examination.