Cytohistologic Diagnosis of Material Aspirated from Stomach: Accuracy of Diagnosis of Cancer, Ulcer and Gastritis from Paraffin-Embedded Washings

Autor: Fred H. Bishop, Howard L. Richardson, Frank B. Queen
Rok vydání: 1949
Předmět:
Zdroj: American Journal of Clinical Pathology. 19:328-340
ISSN: 1943-7722
0002-9173
DOI: 10.1093/ajcp/19.4.328
Popis: Attempts to discover methods and establish criteria by which single cancer cells could be reliably identified • n • • have been either impractical for routine diagnosis or unreliable; and pathologists have continued to rely upon patterns of growth in tissue rather than upon the appearance of individual cells for diagnosis. The feasibility of the recognition of detached cells of uterine cancer in smears of vaginal fluid was demonstrated by Papanicolaou in 1928. Papanicolaou and Traut in 1943 showed the procedure to be highly reliable in a series of 3014 patients. Since then there has been a renewal of interest in cytologic methods of cancer diagnosis. Fluids from a variety of sources have been studied by an increasing number of investigators, using Papanicolaou's method or various modifications. Published work now indicates that the cytologic diagnosis is highly reliable in fluids from a variety of sources, equaling that of the biopsy in some. To date, perhaps the greatest accuracy has been attained in the diagnosis of cancer of the uterus and cancer of the lung, with claims of accuracy from 96 to 99.7 per cent in uterine cancer,' and of 82.4 per cent in pulmonary cancer. In April 1948 a conference of 61 pathologists and clinicians was called by the American Cancer Society for the purpose of evaluating the status of the cytologic .method. It was concluded that the value of the cytologic method was established in some fields and that investigation of its usefulness in other fields should be continued. Since the early recognition of cancer of the stomach is one of the most difficult diagnostic problems, gastric fluids have been studied by several workers, chiefly with the object of detecting cancer. Cancer of the stomach is the most common of malignant diseases. I t accounts for approximately 2 per cent of all deaths and 16.2 per cent of all cancer deaths in the United States. I t is also one of the least curable of cancers. Livingston and Pack stated that definitive cures in unselected patients with gastric cancer are probably in the range of 2 per cent. Walters, Gray and Priestly in 1942 reported 6.2 per cent five year cures in a series of 10,890 cases. Abrahamson and Hinton considered only 5 per cent of
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