A conventional smear versus cell block method for malignant cell detection in ascites or peritoneal washing in endometrial and ovarian cancer

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND | 2020. Objective: To compare the malignant cell detection rate between the conventional smear and the cell block method in ascites or peritoneal washing in endometrial and ovarian cancer. Materials and Methods: A cross-sectional study was conducted in 65 endometrial and presumed ovarian cancer patients who underwent surgical staging between August 2017 and February 2018 at Ramathibodi Hospital. All ascites or peritoneal washing fluids were examined by conventional smear and cell block method to detect malignant cells. The results were interpreted and reviewed by two cytologists. If the results were inconsistent or suspicious, re-interpretation and immunohistochemistry dyes were used to finalize the results. Results: Sixty-five specimens were examined. Conventional smear revealed negative for malignancy in 57 specimens and positive for malignancy in eight specimens. The cell block method revealed negative for malignancy in 52 specimens and positive for malignancy in 13 specimens. The cell block method had a statistically significant higher rate of malignancy detection (20.0% versus 12.3%, p<0.001). Conclusion: The cell block method increased the malignant cell detection rate. In addition, the cell block method has more advantages and the ability to perform further immunohistochemistry staining for a definitive outcome in suspicious cases.