<b>Gastric cytology: a supplement to early diagnosis of gastric malignancies</b>

<b>Introduction</b>: Gastric cancer is the fifth most common malignancy worldwide with high morbidity and mortality. Endoscopic gastric cytology and biopsy aid in early diagnosis and management. This study evaluates the diagnostic yield of gastric cytology in diagnosing gastric lesions with histopathology as the gold standard.<b>Methods</b>: This retrospective, cross-sectional study was conducted in the Department of Pathology for a period of 3.5 years. The cases with clinical suspicion of gastric malignancy and those who have had both cytology and histopathology examination were included. Cytology results were reported as positive for malignancy, suspicious for malignancy, atypical cells- favor reactive and negative for malignancy. The cytology and histopathology results were correlated, and descriptive statistics were used to analyze data.<b>Results</b>: Among 118 patients included in the study, 103 cases were malignant and 15 were nonmalignant. Out of 103 malignant cases, 89 cases were detected in cytology. False positive cases consisted of 4 gastritis with florid reactive atypia and one with moderate dysplasia. False negative cases were seen more often in diffuse and intestinal subtype of adenocarcinoma, followed by non-Hodgkin lymphoma. Sensitivity and specificity were found to be 86.41% and 66.67% respectively. Positive predictive value of 94.68% with 41.67% negative predictive value and diagnostic accuracy of 83.90%.<b>Conclusion</b>: Gastric cytology is a reliable screening and diagnostic tool with a high positive predictive value and acceptable sensitivity. Negative cytology in endoscopically suspected cases of gastric malignancy should always be correlated with biopsy reports. Gastric malignancy is known to be present as diffuse thickening of gastric wall, like diffuse subtype of adenocarcinoma and non-Hodgkin lymphoma is a pitfall on cytology because of low cellularity. Gastric cytology is a cost effective and rapidly performed technique with high positive predictive value, sensitivity and diagnostic accuracy.<b>引言</b>：胃癌是全球第五大常见恶性肿瘤，具有较高的发病率与死亡率。胃镜下胃细胞学检查（endoscopic gastric cytology）与活检（biopsy）有助于胃癌的早期诊断与诊疗。本研究以组织病理学（histopathology）为金标准，评估胃细胞学检查对胃部病变的诊断效能。 <b>方法</b>：本研究为回顾性横断面研究，于病理科开展，研究周期为3.5年。纳入标准为临床疑似胃癌且同时接受了细胞学与组织病理学检查的病例。细胞学检查结果报告分为恶性阳性、恶性可疑、非典型细胞（考虑反应性）以及恶性阴性四类。将细胞学结果与组织病理学结果进行对照，并采用描述性统计学方法分析数据。 <b>结果</b>：本研究共纳入118例患者，其中103例为恶性病变，15例为非恶性病变。在103例恶性病变中，有89例经细胞学检查检出。假阳性病例共5例，其中4例为伴活跃性反应性异型增生的胃炎，1例为中度异型增生。假阴性病例多见于腺癌的弥漫型与肠型亚型，其次为非霍奇金淋巴瘤（non-Hodgkin lymphoma）。本研究中细胞学检查的灵敏度为86.41%，特异度为66.67%；阳性预测值为94.68%，阴性预测值为41.67%，诊断准确率为83.90%。 <b>结论</b>：胃细胞学检查是一种可靠的筛查与诊断工具，具有较高的阳性预测值与可接受的灵敏度。对于内镜下疑似胃癌的病例，若细胞学检查结果为阴性，应始终结合活检报告进行综合研判。胃癌可表现为胃壁弥漫性增厚，如腺癌弥漫型病变，而非霍奇金淋巴瘤因细胞丰富度较低，易成为细胞学检查的诊断陷阱。胃细胞学检查是一种成本效益高、操作快速的技术，具备较高的阳性预测值、灵敏度与诊断准确率。

搜集汇总

背景与挑战

背景概述

该数据集基于一项为期3.5年的回顾性研究，涉及118名患者，旨在评估胃细胞学作为早期诊断胃恶性肿瘤补充工具的效能，以组织病理学为金标准。研究发现胃细胞学具有高阳性预测值（94.68%）和可接受的敏感性（86.41%），是一种可靠且成本效益高的筛查和诊断方法，尤其适用于胃腺癌等病变，但需注意在低细胞性病例中可能存在假阴性风险。