Objective: To investigate the relationship of positive rate of peritoneal exfoliated gastric cancer cells with the volume of peritoneal lavage fluid.
Methods: Exfoliative cytology of peritoneal lavage was performed at the time of laparotomy for 185 patients with gastric cancer from June 2012 to March 2014 in our department, and the clinicopathological data were analyzed retrospectively. According to the volume of saline irrigation, patients were divided into 200 ml group (40 cases), 500 ml group (45 cases) and 1000 ml group (100 cases). The positive rates of peritoneal exfoliated cells among three groups were compared, and then the associated clinicopathological factors were further analyzed in the highest group.
Results: The positive rates of exfoliated cancer cells were 5%(2/40),11%(5/45) and 19%(19/100) in the 200 ml group, 500 ml group and 1000 ml group respectively. The positive rate of exfoliated cancer cells was highest in the 1000 ml group, and was significantly different as compared to the 200 ml group(P=0.036), but not significantly different as compared to the 500 ml group (P>0.05). Multivariate Logistic regression analysis of 1000 ml group showed that age less than sixty years(OR=12.31, 95% CI:2.05-74.11, P=0.006), circumferential infiltration(OR=0.09, 95% CI:0.01-0.84, P=0.034) and T4 (OR=0.09, 95% CI:0.01-0.56, P=0.010) were independent risk factors for positive rate of exfoliated cancer cells.
Conclusions: Greater volume of saline irrigation can improve the positive rate of peritoneal exfoliated cells in gastric cancer especially for patients with younger age, circumferential infiltration and serosal invasion. The recommended volume should not be less than 1000 ml.