RESUMO
El cancer del aparato digestivo es una causa frecuente de mortalidad, sin embargo su prevalencia en nuestro medio se desconece. En este trabajo se informan los resultados obtenidos en un analisis retrospectivo de 70,055 estudios histopatologicos; 61,533 correspondieron a material quirurgico-biopsia o pieza operatoria - de cinco anos (1975-1980), de ellos 673 (1.09%) presentaban proceso neoplasico maligno del aparato digestivo; los restantes 8, 522 correspondieron o protocolos de necropsia de 20 anos (1960-1980) en los que 352 (4.13%) presentaban igual patologia.Tanto en piezas operatorias como en necropsias la variedad histologica mas frecuente fue el carcinoma 82.6% y 92.8% respectivamente, seguida del linfoma. Por lo que hace a la localizacion del proceso los resultados varian igualmente segun el material motivo de estudio; en piezas operatorias los carcinomas mas frecuentes fueron: estomago (37.95%), vesicula y vias biliares (24.29%), colon (19.25%); mientras que al estudiar el material de necropsias la frecuencia fue: vesiculas y vias biliares (35.47%) pancreas (22.62%) y estomago (18.45%).Se senalan aspectos epidemiologicos, clinicos y terapeuticos de las neoplasias mas frecuentes informadas en esta revision
Assuntos
Humanos , Neoplasias do Sistema DigestórioRESUMO
A prospective and comparative study between the citology obtained through gastric washing and endoscopic (biopsy and brushing) for the diagnostic of the gastric neoplasias was carried at the Hospital de Especialidades del Centro Médico La Raza. Twenty one patients with benign gastric ulcer and 18 patients with gastric neoplasia (Two lymphomas and 16 adenocarcinomas) which we checked through surgery, necropsy or clinic evolution were studied. From 21 cases of gastric ulcer, the washing produced enough material for diagnosis in 17 of them (81%); in 16 of these neoplasia was excluded (94.1%) with false positive (5.9%). The endoscopic regained 100% of useful material and in a 100% ignored neoplasia. From 18 neoplasia cases, gastric washing produced material for 14 of them (77.8%); in 10 of these (71.4%) it made a diagnostic with 4 false negatives (28.6%); Endoscopic collected material in a 100% and the accuracy diagnostic was of 17 (94.4%) with one false negative (5.6%). Gastric washing has a high index of uselless for diagnostic from 39 samples, 8 were useless and from these, autolisis was the mein cause. Citology through gastric washing is usefull for neoplasm diagnosis in those cases in which endoscopy would be contraindicated or in those in which it is absent.
Assuntos
Adenocarcinoma/diagnóstico , Lavagem Gástrica , Linfoma/diagnóstico , Neoplasias Gástricas/diagnóstico , Citodiagnóstico/métodos , Gastroscopia , Humanos , Úlcera Gástrica/diagnósticoRESUMO
Biopsy of the pancreas frequently is followed by complications, this is why the transoperative aspiration biopsy has been recomended. During the last 2 years we used this procedure in 46 patients; in each case, one or several aspirations were done in the more-representative area of the pancreatic pathology. With the aspirated material a smear was fixed and treated with H-E stain. Biopsy was negative for carcinoma in 30 patients (65.2%), positive in 12 (26.0%), insuficient material results in other 4 (8.6%) we consider that the procedure was useful in the 82.6% of the cases and help to elect more adecuate surgical tecnic. There were no complications and we concluded that this is not a harmful procedure. The correct interpretation of the citology depends on the experience of the pathologyst with this method, to increase the percentage of correct diagnosis.