Peritoneal fluid cytology in ovarian carcinoma

Abstract

OBJECTIVES: 1. Determine the sensitivity of cytology in the detection of spread of ovarian carcinoma to the peritoneum. 2. Determine whether tumour size, type and differentiation, and the volume and nature of the peritoneal fluid are related to the presence of metastasis. METHOD: Peritoneal fluid cytology specimens in 28 consecutive malignant tumours were studied with respect to size of tumour, and volume and presence of blood in the peritoneal fluid. The accompanying omentectomy specimens were examined for deposits. RESULTS: 12 out of 28 ovarian carcinomas had histologically proven omental deposits. Of these only 7 were cytologically positive for malignant cells. Only I specimen was cytologically positive in the absence of histological evidence of peritoneal deposits. 10/12 carcinomas with histologically proven deposits were accompanied by > 1000 ml of blood stained peritoneal fluid. We did not find a correlation between tumour size, type and differentiation and the presence of metastatic spread. The sensitivity of cytological assessment of spread of ovarian carcinoma was 66.6%. However cytology was 100% specific. CONCLUSION: The sensitivity of cytological assessment of peritoneal fluid in the detection of peritoneal spread was low (measured against histologically proven omental deposits). The fluid volume and presence of blood appear related to tumour spread, while tumour size, type and differentiation were unrelated.