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Ana Maria Creţu et al. / Ovidius University Annals, Biology-Ecology Series 14: 157-162 (2010) However, comparing the results, after performing peritoneal fluid cytology, with those obtained by macroscopic evaluation, of the 40 effusions associated with at least one malignancy, only 6 (15%) were founded to be red colored (hemorrhagic), emphasizing that it does not exist any relationship between peritoneal fluid containing cancer cells and fluid color. After conducting the Riwalta reactions [10], the 81 peritoneal effusions were classified in: 29 (35.80%) transudates peritoneal fluid (with low cell density and low protein content, which is usually accumulated in benign conditions) and 43 (53.08%) exudate (effusions with high cell density and high protein content, which is accumulated most in malignant conditions), and 9 (11.11%) mixed, intermediate peritoneal effusions. Thus, peritoneal fluids were classified into three groups: group I (transudates), group II (intermediate, mixed) and group III (exudates) (Table 2). Table 2. Distribution of cases after Riwalta reaction Lots Primary cancer Lot I (n=41) Lot II (n=40) Transudates (N=29) Mixed (N=9) Exudates (N=43) CB 21 3 17 CH (4) 1 1 2 CO (18) 3 0 15 CGI (9) 1 2 6 CM (4) 2 2 0 CP (3) 1 1 1 MP (2) 0 0 2 Since only 26/40, 65% of peritoneal effusions associated with different type of cancer resulted to have characters of exudates, and only 21/41, 51.21% of effusions associated with liver cirrhosis were shown to be transudates, it follows that, by conducting the Riwalta reaction, it can determine the benign or malignant nature of effusions in a proportion of 58.10% (Fig.6). Cell smear appearance had a various cells populations and the quantitative analysis of effusions was not enough useful in establishing the final diagnosis. There were observed 7 cell types present in variable number. Proliferative capacity of tumor cells - tumor aggressiveness - is an important 161 element in cytology grading of malignancy, and was quantified by mitosis counting. Fig 6. The benign or malignant nature of effusions after conducting the Riwalta reaction In smears classified as benign, isolated cells represented 90% of total cells, cell groups recovered to a rate of 10%. 5% were represented by free nucleus or cells with damaged cytoplasm. Mesothelial cells (33%) (33 cells of 100 elements) and lymphocytes (30%) were the majority cell type in the group of benign peritoneal effusions, followed by macrophages (17%), polymorphonuclear leukocytes (PMN) (9%) and erythrocytes (7%). Average of total number of mitosis founded in studied smears was 3mitosis/smears (Table 3). Cellular composition of effusions founded to be suspicious for malignancy was similar with the one of benign peritoneal effusions: mesothelial cells (28%) (28 cells of 100 items) and lymphocytes (26%) were the majority cell type, followed by neutrophils (13%), atypical cells, suspicious for malignancy (9%), erythrocytes (9%) and macrophages (7%). Average of total number of mitosis founded in studied smears was 7 mitosis/smears (Table 3). In the group of patients with malignant cancer, mesothelial cells represented 29% and erythrocytes 21%, followed by lymphocytes (18%), polymorphonuclear leukocytes (16%), macrophages (4%) and malignant cells (4%), average of total number of mitosis was 9 mitoses / cell smear (Figure 7).
The clinical utility of aditional methodes... / Ovidius University Annals, Biology-Ecology Series 14: 157-162 (2010) Tabel 3. The percentage of cellular elements (%) BE* AE* ME* Mesothelial cells 33 28 29 Atipical cells 0 9 0 Malignant cells 0 0 3 erythrocytes, 7 9 21 lymphocytes 30 26 18 PMN 9 13 16 macrophages 17 7 4 mitosis / cell smear 2 7 9 Average 12,25 12,375 12,5 standard Deviation 13,15566 9,738546 10,12776 p(t
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VOLUM OMAGIAL - Facultatea de Ştiinţe ale Naturii şi Ştiinţe Agricole

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