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  • Title: Comparison of diaphragmatic wash and scrape specimens in staging of women with ovarian cancer.
    Author: Eltabbakh GH, Mount SL.
    Journal: Gynecol Oncol; 2001 Jun; 81(3):461-5. PubMed ID: 11371139.
    Abstract:
    OBJECTIVE: The best technique for obtaining cytologic specimens necessary for evaluation of diaphragmatic spread among women undergoing surgical staging for ovarian cancer has yet to be determined. The aim of the current study was to compare two methods for obtaining diaphragmatic cytology-wash and scrape-in accuracy, correlation to clinical findings, and smear quality. METHODS: We conducted a prospective study among women undergoing surgical staging for ovarian cancer. In each patient diaphragmatic scrape and wash specimens were obtained, then the undersurface of the diaphragm was inspected and palpated. The smears were examined for presence of cancer cells, correlated to clinical findings, and scored for quality (cellularity, preservation, and background). RESULTS: In 46 consecutive patients with stage I-III ovarian cancer, the diaphragm was clinically involved in 12 (26.1%). Malignant cells were demonstrated in 21 (45.7%) of wash and scrape specimens. There was perfect agreement between washes and scrapes and good agreement between clinical evaluation and scrapes or washes (kappa = 1.0 and 0.592, respectively). Wash specimens had significantly higher overall smear quality and cellularity scores (6.26 +/- 1.26 vs 6.11 +/- 1.06, P < 0.02, and 2.20 +/- 0.81 vs 1.85 +/- 0.76, P < 0.05, respectively). CONCLUSION: Although diaphragmatic wash specimens provide better-quality smears than scrape specimens, both techniques are equally diagnostic of diaphragmatic involvement in women undergoing surgical staging for ovarian cancer.
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