Clinical significance of immunocytochemical staining for peritoneal lavage cytology in pancreatic cancer
Clinical significance of immunocytochemical staining for peritoneal lavage cytology in pancreatic cancer
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免疫细胞化学染色对胰腺癌腹腔灌洗细胞学检查的临床意义
DOI：
10.1016/j.surg.2022.09.025
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发表时间：
2022
期刊：
影响因子：
3.8
通讯作者：
Uesaka Katsuhiko
中科院分区：
文献类型：
--
作者：
Kubo Hidemasa;Ohgi Katsuhisa;Ohike Nobuyuki;Tone Kiyoshi;Norose Tomoko;Sugiura Teiichi;Ashida Ryo;Yamada Mihoko;Otsuka Shimpei;Uesaka Katsuhiko
背景在我院，胰腺导管腺癌的腹腔灌洗细胞学检查是通过术中巴氏染色快速诊断（细胞学快速）和免疫细胞化学染色最终诊断（细胞学最终）来进行的。然而，细胞学最终的临床意义尚未阐明。MethodsA共675例胰腺导管腺癌患者谁接受胰腺切除术和细胞学2002年至2018年进行了回顾性分析。结果43例患者（6.4%）被诊断为细胞学快速（+），所有患者最终均被诊断为细胞学最终（+）。在632例细胞学快速（-）的患者中，19例（3.0%）最终诊断为细胞学最终（+）。快速细胞学（+）和快速细胞学（-）患者的总生存期无统计学显著差异（中位生存时间26.4 vs 32.9个月;P= 0.106）。相比之下，经快速细胞学诊断为假阴性结果的患者的总生存期明显低于诊断为真阴性的患者（18.7 vs 34.8个月;P= 0.031）。最终细胞学结果为+的患者的总生存期显著低于最终细胞学结果为-的患者（23.6 vs 34.8个月;P= 0.012）。多变量分析表明，细胞学最终（+）是一个独立的预后因素OS（风险比= 1.43;P= 0.049），而细胞学快速（+）是not.ConclusionImmunocytochemical染色可能是一个有用的补充，诊断细胞学常规巴氏染色胰腺导管腺癌患者。
BackgroundPeritoneal lavage cytology for pancreatic ductal adenocarcinoma is conducted with both an intraoperative rapid diagnosis by Papanicolaou staining (cytology–rapid) and a final diagnosis by immunocytochemical staining at a later date (cytology–final) in our hospital. However, the clinical significance of cytology–final has not yet been elucidated.MethodsA total of 675 pancreatic ductal adenocarcinoma patients who underwent pancreatectomy and cytology between 2002 and 2018 were retrospectively reviewed. Diagnostic results of cytology–rapid and cytology–final and survival outcomes were analyzed.ResultsA total of 43 patients (6.4%) were diagnosed as cytology–rapid (+), and all of them were ultimately diagnosed as cytology–final (+). Among the 632 patients with cytology–rapid (–), 19 (3.0%) were eventually diagnosed as cytology–final (+). The overall survival of patients with cytology–rapid (+) and that of patients with cytology–rapid (–) did not differ to a statistically significant extent (median survival time 26.4 vs 32.9 months;P= .106). In contrast, the overall survival of patients who were diagnosed as a false-negative result by cytology–rapid was significantly worse than that of patients diagnosed as a true negative (18.7 vs 34.8 months;P= .031). The overall survival of patients with cytology–final (+) was significantly worse than that of patients with cytology–final (–) (23.6 vs 34.8 months;P= .012). A multivariate analysis showed that cytology–final (+) was an independent prognostic factor for the OS (hazard ratio = 1.43;P= .049), whereas cytology–rapid (+) was not.ConclusionImmunocytochemical staining may be a useful complement to a diagnosis of cytology by conventional Papanicolaou staining in pancreatic ductal adenocarcinoma patients.