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Serosal imprint cytology in colonic cancer: a simple staging technique

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Abstract

Accurate staging of colonic cancer is essential in defining the rational use of adjuvant treatments. Recent studies have shown that prognostic accuracy can be significantly improved by recognition of primary tumour extension to the free serosal surface. This study compares the technical results of serosal imprint cytology with the results of histology in assessing serosal involvement. When analysed in terms of the modified Dukes' staging the results of cytology imprints taken from the peritoneum overlying the colonic primary were positive for tumour cells in 4/13 Dukes' B, 7/14 Dukes' C, and 5/9 metastatic cancers. Imprint cytology was positive in 6/7 Dukes' B and C cases with histological serosal invasion and was suspicious in the remaining case. However, a further 5/20 cases without identified invasion on routine histology also had positive cytology. Imprint cytology is an adjunct to routine histology which is easily performed and allows more precise staging of serosal involvement in Dukes' B and C colonic cancers. Final evaluation of this technique requires long-term follow-up of patients.

Résumé

Un staging précis des cancers coliques est essentiel pour préciser l'emploi rationnel de traitement adjuvants. Les études récentes ont montré que la valeur prognostique peut être significativement améliorée par l'identification d'une extension de la tumeur primaire à la surface séreuse libre. Cette étude compare les résultats d'empreintes cytologiques de la séreuse avec les résultats de l'examen histologique pour déterminer l'extension séreuse des tumeurs. En utilisant une classification de Dukes modifiée les résultats d'empreintes cytologiques prélevées sur le péritoine recouvrant des tumeurs primitives du colon ont montré la présence de cellules tumorales dans 4/13 Dukes B, dans 7/14 Dukes C et 5/9 cancers métastatiques. Les empreintes cytologiques ont été positives chez 6/7 Dukes B et C présentant une invasion histologique de la séreuse et l'empreinte était suspecte dans le dernier cas. Toutefois 5/20 cas sans identification d'une extension séreuse à l'examen histologique présentent une cytologie positive. L'empreinte cytologique est une investigation complémentaire à l'examen histologique de routine; cette empriente est de réalisation aisée et permet de préciser le staging d'extension séreuse dans les cancers coliques au stade de Dukes B et C. L'évaluation finale de cette technique nécessite un suivi à long terme des patients.

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Murphy, P.D., Hoffman, J., Karczenski, C. et al. Serosal imprint cytology in colonic cancer: a simple staging technique. Int J Colorect Dis 9, 96–99 (1994). https://doi.org/10.1007/BF00699421

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Keywords

  • Colonic Cancer
  • Final Evaluation
  • Accurate Staging
  • Precise Staging
  • Colonic Primary