Naslov
Role of FNA cytology in gastroenterology and hepatology

Autori
Papa, Branko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Knjiga sažetaka 3. Hrvatskog kongresa patologije i sudske medicine.3. Hrvatski kongres kliničke citologije. 1. Hrvatski simpozij citotehnologije / Kardum, Ika - Zagreb, 2005

Skup
3. Hrvatskog kongresa patologije i sudske medicine.3. Hrvatski kongres kliničke citologije. 1. Hrvatski simpozij citotehnologije

Mjesto i datum
Opatija, Hrvatska, 08.05.2005. - 11.05.2005

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
FNA cytology

Sažetak
In the last decades cytodiagnosis has become a method of choice in routine evaluation of patients with gastrointestinal malignancies. Immediate diagnosis of malignancy of the oesophagus, stomach, duodenum, colorectum and biliary tract could be achieved by analysis of imprint or brushing specimens obtained during the endoscopic session. Early detection and exact estimation of the nature of these tumours is of essential importance for treatment and for prognosis. US- or CT- guided FNA cytology plays an important role in the diagnosis and classification of malignancies of the liver. Cytology analysis should be subsequently correlated with histopathology which facilitates exact tumour typing and assessment The role of cytology is crucial in the diagnosis of peritoneal cavity fluids and in the differentiation serous surface carcinoma of the peritoneum from other morphologycally similar tumours including ovarial carcinoma. Improvement in diagnosis of acute GI diseases such as acute appendicitis and acute pancreatitis could be achieved by using FNA cytology. Diagnosis of infected pancreatic necrosis – by using US guided FNA analysis has become the standard procedure in the treatment of severe acute pancreatitis. US guided FNA is recommended for all patients with necrotizing pancreatitis in whom SIRS persists beyond the first week after onset of symptoms. This approach could substanially improve prognosis for patients with these severe disease. FNA cytology is of great value in the assesment of pancreatic and peripancreatic malignancies. Preoperative assesment of pancreatic tumour extension allows to choose the best treatment options and to reduce the nummber of unnecesarry explorative laparotomies. Intraoperative FNA in suspected pancreatic cancer associated with chronic pancreatitis is a suitable method for intrasurgical confimation of pancreatic cancer.It can be performed safely, effectively and rapidly. Peritoneal washing-cytology at laparotomy is realible method for detecting metastatic spread of pancreatic cancer. Peritoneal metastases are the second most common site of involment, following the liver. Cytologycal diagnosis could be improved by use of immunocytochemical staining methods. The method of perfoming K-ras point mutation has potential to become the standard for peritoneal washing cytology in pancreatic cancer. It should be pointed out that false negative FNA cytology could postponne diagnosis and treatment of GI malignancies. In the diagnosis of small resectable pancreatic tumours it is not necessary to wait for cytologycally proven diagnosis. When there are enough data from clinical and imaging methods (CT, ERCP) for the diagnosis of pancreatic cancer it is not necessary to prove the diagnosis cytologycally before performing pancreatectomy Diagnosis of pancreatic cancer in early stage could be improved by use of cytology and tumor markers analysis in pure pancreatic juice. In the population under increased risk for developing pancreatic cancer (such as chronic pancreatitis patients) cytologycal analysis of pure pancreatic juice combined with elevated levels of CEA and Ca 19.9 in the juice are usefull tools for pancreatic cancer diagnosis even in the early stages.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA