COMPARISON OF CYTOLOGICAL AND HISTOLOGICAL ANALYSIS OF GASTRIC MUCOSA BIOPSY IN DIAGNOSING MALIGNANT DISEASES

Autori:

IVANA KNEŽEVIĆ ŠTROMAR, JASMINKA JAKIĆ-RAZUMOVIĆ, ANKA KNEŽEVIĆ-OBAD, JOZO KNEŽEVIĆ

Sažetak
Cilj je rada pokazati vrijednost citološke analize otiska biopsije sluznice želuca u dijagnozi malignih bolesti, u usporedbi s patohistološkom analizom. U studiju je uključeno 70 bolesnika s promjenama sluznice želuca endoskopski sumnjivim na zloćudnu bolest, kod kojih je učinjena biopsija sluznice radi postavljanja dijagnoze patohistološkom analizom, a istodobno su učinjeni i otisci biopsije na staklu radi citološke analize uzorka. U istraživanoj skupini bolesnika 46 (65,7%) bilo je muškog, a 24 (34,2%) ženskog spola. Prosječna dob bolesnika bila je 60 godina, u rasponu od 36 do 83 godine. U 34 bolesnika endoskopskim pregledom postavljena je sumnja na zloćudni proces, u 23 bolesnika opisan je želučani vrijed, tri bolesnika imala su vrijed dvanaesnika, u 5 bolesnika nađena je polipozna tvorba, dok su u 5 bolesnika nađene promjene koje odgovaraju gastritisu. U 42 bolesnika histološki je potvrđena dijagnoza zloćudnog tumora, dok je u preparatima otiska biopsije dijagnoza zloćudnog tumora citološki postavljena u 46 bolesnika. U 5 bolesnika citološki su pronađene zloćudne stanice, koje nisu dokazane patohistološki. U jednog bolesnika patohistološkom analizom nađen je zloćudni tumor u bioptičkom materijalu, dok u preparatu otiska citološki nije nađeno zloćudnih stanica. Rezultati su pokazali da je citološka analiza otiska bioptičkog materijala sluznice želuca prikladna metoda za dokazivanje zloćudnih tumora. U slučaju pozitivne citološke analize, a negativnog patohistološkog nalaza treba preporučiti ponavljanje biopsije uz citološku i patohistološku analizu uzorka.
Summary

Summary. The aim of this study was to determine the value of cytological analysis of an imprint of gastric mucosa biopsy compared to the histological evaluation, in diagnosing malignant diseases of gastric mucosa. In this study 70 patients, with changes of gastric mucosa endoscopically suspect of malignancy were included. Biopsy and imprint of gastric mucosa were performed in order to obtain morphological diagnosis. In the investigated group 46 patients (65.7%) were male, 24 patients (34.2%) were female, mean age 60 years (36–83). In 34 patients endoscopy finding suggested malignancy, in 23 endoscopy finding was described as gastric ulcer, in three as duodenal ulcer, in five as polyp, and in five as gastritis. In 42 patients malignancy was proved by pathohistological examination while in imprint smears of gastric mucosa biopsy the diagnosis of malignancy was made in 46 patients. In five patients malignant cells were found on cytological examination of imprint smears, and pathohistological examination did not find malignant tumour. In one patient malignant tumour was found on pathohistological examination, and cytological examination of an imprint smear did not find malignant cells. The results indicate that cytological examination of an imprint smear of gastric mucosa biopsy is satisfactory for proving malignant changes. In case of positive cytological and negative pathohistological analysis, it is recommended to repeat biopsy and imprint cytology in order to obtain morphological diagnosis.

Volumen: 11-12, 2004

Liječ Vjesn 2004;126:287–290

Anka Knežević-Obad, Ivana Knežević-Štromar, JOZO KNEŽEVIĆ, Jasminka Jakić-Razumović

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