title: Diagnosis of visceral pleural invasion by lung cancer using intraoperative touch cytology.
abstract: BACKGROUND
  Invasion to the visceral pleura is an important component of lung cancer staging and an independent prognostic factor. However, the accuracy of pathologic examination depends on how the sections are made, and the pathologist may miss the most invaded part of the pleura. Therefore, we have designed "touch" cytology in an effort to more accurately diagnose the pleural invasion by lung cancer.
  
  
  METHODS
  Immediately after thoracotomy, the surface of the visceral pleura just above the tumor was gently touched by a glass slide without scrubbing in 100 patients who simultaneously underwent pleural lavage cytology or cytology of the subclinical pleural effusion.
  
  
  RESULTS
  Seventeen percent of the tumors were diagnosed as invading the visceral pleura by touch cytology. Lavage cytology was found to be positive in 7%. In reference to the pathologic examination of the tumor specimen, touch cytology was found to be positive in all of p3, 5 out of 6 of p2, 5 out of 30 of p1, and 5 out of 62 of p0 cases. Touch cytology correctly diagnosed all the positive cases detected by lavage or effusion cytology.
  
  
  CONCLUSIONS
  This study suggests that our method is useful in detecting the visceral pleural invasion and raises a possibility that pathologic p0 and p1 lung cancers include a subset of patients with tumor cells exposed on the pleural surface.
authors.affiliation: Department of Surgery II, Nagoya City University Medical School, Nagoya, Japan.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Saito
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Yamakawa
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kiriyama
authors.forename: Ichiro
authors.initials: I
authors.lastname: Fukai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kondo
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kaji
authors.forename: Motoki
authors.initials: M
authors.lastname: Yano
authors.forename: Tomoki
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Fujii
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000473:pathology* / Q000601:surgery; D018288:Carcinoma, Small Cell / Q000473:pathology* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000473:pathology* / Q000601:surgery; D016066:Pleural Effusion, Malignant / Q000473:pathology* / Q000601:surgery; D011379:Prognosis