Laparoscopic cytology--an evaluation.
Cytological sampling by abrasion and/or aspiration was done in a consecutive series of 927 patients at the time of laparoscopy. Cytological examination confirmed the diagnosis of malignancy in 312 out of 335 cases of primary or secondary liver cancer (93.1%). Biopsy was positive in 262 out of 303 patients (86.4%). The combined use of cytology and biopsy provided a positive diagnostic accuracy of 97.6%). The cytological report was positive in 215 out of 239 (89.9%) proven extrahepatic malignancies (gallbladder, gynecological, peritoneal). Biopsy was positive in 180 out of 199 cases (90.4%). The combined use of cytology and biopsy provided an accuracy of 95.8%). There was only one false positive diagnosis of malignancy. The sensitivity of laparoscopic cytology was 93.1% and its specificity 100% in liver disease. Sensitivity was 90.3% and specificity 99.4% in other types of abdominal cancer. In these series, cytological examination added 15.6% positive results (liver) and 11.7% (other lesions) to those of biopsy, which was not performed in 89 patients in whom it was considered too risky or technically too difficult.