Prognostic Value Of Intraoperative Peritoneal Lavage Cytology In Patients With Advanced Gastric Cancer

Object: The prognosis of patients with gastric cancer(GC)is generally poor.Peritoneal metastasis has occurred in many patients at the time of diagnosis.This prospective study investigated the relationship between peritoneal lavage cytology and related pathological clinical factors in patients with gastric cancer to determine whether peritoneal lavage cytology can be used as an indicator of peritoneal metastasis and to identify potential risk factors associated with prognosis of positive peritoneal cytology(CY1)gastric cancer patients.Methods: From January 2015 to December 2018,74 patients with primary advanced gastric cancer in Gansu Province Hospital General surgery department one were collected.All the patients provided informed written consent for the acquisition.Primary gastric cancer confirmed by histopathological examination before surgery and all the patients had not received Anti-tumor therapy such as radiotherapy,chemotherapy.The Ethics Committee of the hospital approved the protocol of the study.Ascites or peritoneal lavage fluid was collected intraoperative and standard cytological examination was carried out to analyze the sensitivity and specificity of peritoneal lavage cells and to explore the relationship between CY and related pathological clinical factors.The potential risk factors related to the prognosis of the patients were analyzed,and the SPSS 22.0 software was used for statistical analysis.Results: Among the 74 patients,51(68.9%)were CY1.The sensitivity and specificity of CY were 66.7% and 69.8%,respectively.Among clinical pathological factors,we found that only PLC(peritoneal lavage cytology)was associated with peritoneal metastasis(P = 0.004),while no association with age,sex,radical surgery,tumor size,tumor location,Lauren classification,T grade,TNM stage,CEA,CA19-9 and CA125,tumor differentiation,lymph node metastasis(P>0.05).Survival analysis showed that adjuvant chemotherapy(P = 0.020)and surgical resection(P = 0.034)were related to the prognosis of CY1 gastric cancer patients,while no association with age,sex,tumor size,tumor location,Lauren classification,T grade,TNM stage,CEA,CA19-9 and CA125,tumor differentiation,lymph node metasta sis(P>0.05).Conclusion: Peritoneal metastasis of gastric cancer was correlated with peritoneal cytology.Adjuvant chemotherapy and surgical resection were related to prognosis of CY1 gastric cancer patients.Chemotherapy combined with surgical resection may improve the prognosis of patients who were CY1.