Clinical significance of immunocytochemical staining for peritoneal lavage cytology in pancreatic cancer

Published:November 09, 2022DOI:



      Peritoneal lavage cytology for pancreatic ductal adenocarcinoma is conducted with both an intraoperative rapid diagnosis by Papanicolaou staining (cytology–rapid) and a final diagnosis by immunocytochemical staining at a later date (cytology–final) in our hospital. However, the clinical significance of cytology–final has not yet been elucidated.


      A total of 675 pancreatic ductal adenocarcinoma patients who underwent pancreatectomy and cytology between 2002 and 2018 were retrospectively reviewed. Diagnostic results of cytology–rapid and cytology–final and survival outcomes were analyzed.


      A total of 43 patients (6.4%) were diagnosed as cytology–rapid (+), and all of them were ultimately diagnosed as cytology–final (+). Among the 632 patients with cytology–rapid (–), 19 (3.0%) were eventually diagnosed as cytology–final (+). The overall survival of patients with cytology–rapid (+) and that of patients with cytology–rapid (–) did not differ to a statistically significant extent (median survival time 26.4 vs 32.9 months; P = .106). In contrast, the overall survival of patients who were diagnosed as a false-negative result by cytology–rapid was significantly worse than that of patients diagnosed as a true negative (18.7 vs 34.8 months; P = .031). The overall survival of patients with cytology–final (+) was significantly worse than that of patients with cytology–final (–) (23.6 vs 34.8 months; P = .012). A multivariate analysis showed that cytology–final (+) was an independent prognostic factor for the OS (hazard ratio = 1.43; P = .049), whereas cytology–rapid (+) was not.


      Immunocytochemical staining may be a useful complement to a diagnosis of cytology by conventional Papanicolaou staining in pancreatic ductal adenocarcinoma patients.
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