胃癌細胞診の検討

抄録

Direct smears were made from resected stomachs, fixed in ether-alcohl and stained by Wright's method.
The average areas of nuclei and nucleoli were respectively 148μ²and 11.2μ²in adenocarcinomas, 148μ²and 11.8μ²in scirrhous carcinomas, 118μ²and 8.7μ²in medullary carcinomas, 118μ²and 6.4μ²in gastric ulcers.
The cells, which had nuclei larger than 300μ²or nucleoli larger than 40μ², were generally malignant.
But some of malignant characteristics were also seen both in cases of gastric ulcer and gastric polyp. For instance increased nuclearcytoplasmic ratio, hyperchromasia, thickening of the nuclear membrane and deep staining of the cytoplasm were also seen in cases of gastric ulcer. However, enlarged nucleolus, typical mitosis and cytoplasmic inclusion were rarely observed in cases of gastric ulcer. Enlarged nucleus, giant nucleus, aberrant chromatin pattern, irregular outline of the nucleus, multinucleation, engulfment of one cell by another and vacuolation were never seen in gastric ulcer. So we must always keep this fact in mind in the cytodiagnosis of gastric cancer.
Of the 35 cases of histologically proved cancer, 31 were correctly diagnosed by this smear method and in the remaining four the examination proved negative. In three of these negative cases, the cancer surf ace was exposed only slightly or not at all.
Of the eight cases of benign gastric ulcer, seven were correctly diagnosed and one was suspicious.
Of the four cases of benign gastric polyp, two were correctly diagnosed but other two were false positive.