HE CYTOLOGICAL method in gastric cancer
T detection is now well established. Yet, a review of the literature reveals that the percentage of detection achieved by different workers varies greatly. One may also observe that the results obtained by the same cytologists vary. It is generally stressed that the method of collection of the specimen is of decisive importance.
Two methods of obtaining cellular material are in use. T h e first is based on the mechaiiical removal of mucosal fragments and cells by either a gastric balloon or a gastric brush. T h e principle of the second method is that of obtaining gastric cells by lavage, using saline or Ringer's solution with or without the addition of a mucolytic agent, such as chymotrypsin or papain. Since the reports of different workers as to the efficiency of different methods often are contradictory, the chief purpose of this investigation was to establish whether there is an advantage to mechanical irritation of mucosa as compared to the lavage of already desquaniated material. T h e first method meets with the patient's disapproval and probably could not be used as a screening method; the second is less objectionable and might be used for screening. T h e gastric balloon method and the chymotrypsin lavage technique were chosen as representatives of the two different methods.
T h e diagnostic limitations and advantages of cytological interpretation in detecting gastric lesions are discussed and illustrated, and the efficiencies of roentgenological and cytological techniques in detecting gastric cancer are compared.