Laparoscopic Cytology - An Evaluation

Summary

Cytological sampling by abrasion and/or aspiration was done in a consecutive series of 927 patients at the time of laparoscopy. Cytological examination confirmed the diagnosis of malignancy in 312 out of 335 cases of primary or secondary liver cancer (93.1 %). Biopsy was positive in 262 out of 303 patients (86.4 %). The combined use of cytology and biopsy provided a positive diagnostic accuracy of 97.6 %.

The cytological report was positive in 215 out of 239 (89.9 %) proven extrahepatic malignancies (gallbladder, gynecological, peritoneal). Biopsy was positive in 180 out of 199 cases (90.4 %). The combined use of cytology and biopsy provided an accuracy of 95.8 %). There was only one false positive diagnosis of malignancy.

The sensitivity of laparoscopic cytology was 93.1 % and its specificity 100 % in liver disease. Sensitivity was 90.3 % and specificity 99.4 % in other types of abdominal cancer.

In these series, cytological examination added 15.6 % positive results (liver) and 11.7 % (other lesions) to those of biopsy, which was not performed in 89 patients in whom it was considered too risky or technically too difficult.

Key words:

Abvasive and aspirative cytology - Peritoneoscopy - Cancer