VOLUM OMAGIAL - Facultatea de Ştiinţe ale Naturii şi Ştiinţe Agricole

The clinical utility of aditional methodes... / Ovidius University Annals, Biology-Ecology Series 14: 157-162 (2010)
From all patients with histopathologic and
clinical data that indicate malignancy, a number of 5
patients (2 / 2, 100% associated with malignant
mesothelioma, 1/4, 25% associated with hepatic
carcinoma, ¼, 25% associated with breast carcinoma,
1/3, 33.33% associated with lung carcinoma) were
deceased before drawing to the final study (a period
of approximately three years from the accumulation
of fluid in the peritoneal cavity), in all cases, the
peritoneal fluid cytology recorded the presence of
malignant cells (Fig. 4).
Fig. 4. Percentage of prognostic survival of patients
included in the study (OC- ovarian cancer, GIC -
gastrointestinal cancer, HC - hepatic cancer, BC –
breast cancer, PC - pulmonary cancer, MM -
malignant mesothelioma)
Thus, the percentage of peritoneal fluid
accumulation in the abdominal cavity is directly
proportional to the tumor stage and also with the
diagnosis of malignant peritoneal effusions, meaning
that the progression of cancer is associated with an
unfavorable prognosis. None of the patients with
ovarian or gastric carcinoma were associated with an
unfavorable prognosis, which indicates that this
patients are available for a longer treatment.
Neoplasia stage, histological grade of neoplasia,
positive cytology of peritoneal fluid and patients age
(61-70 years) were correlated statistically with the
prognosis.
The first step in the analysis of peritoneal fluid
was represented by analysis of the macroscopic point
of view of biological material (peritoneal effusions).
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Thus, it was recorded: the extracted amount, the
product color, transparency and its consistency.
After macroscopic analysis, the most liquids
from the group I was found to shown yellow color
(from very light yellow to orange - yellow), and most
fluid were transparent. In stead, the peritoneal
effusions from group II had a variable macroscopic
appearance: a number of 29/40 (72.5%) were intense
yellow colored and transparents, many of them
(17/29, 42.5% of all liquids associated with a
carcinoma) had tissue fragments occupying
approximately 25-50% from all quantity effusions,
suspended in liquid; 5 (12.5%) showed a yelloworange
fluid and opaque, and a total of six (15%)
were hemorrhagic (deep red), fluid and opaque (Fig.
5). Of these, 19 / 40 (47.5%) had fragments of tissue
suspended in peritoneal effusions. These fragments
were then included in paraffin, stained and examined
microscopically.
We can say that the macroscopic analysis of
peritoneal fluid, associated with cases of cancer are
different from those associated with cases of cirrhosis
only by this tissue fragments founded suspended in
the effusions, with a capacity of discrimination of
47.5%.
Fig. 5. Peritoneal fluid: yellow (a) and hemorrhagic
The registration of the important differences
existing between macroscopic peritoneal fluids is
essential, representing the first way in effusions
discrimination (in transudates and exudates), so that,
the material subjected can provide useful information
for further evaluation of the cells from cytological
smears. It is known that bleeding effusions (deep red)
are often caused by a cancer and that these liquids
often contain cancer cells [9].