OBJECTIVEThe purpose of this study was to explore the value of thin-layer cytology (TLC) in intraoperative fine needle aspiration cytology diagnosis of pancreatic cancer.

METHODSResults of cytological examination with thin-layer smears were compared with that with conventional smears in intraoperative fine-needle aspiration (FNA) biopsy.

RESULTSTotally 271 fine needle aspiration biopsies were performed, among them, 70 were examined with thin-layer smears, showing unsatisfactory smear in 5 cases (7.1%); 201 were examined with conventional smears (CS), showing unsatisfactory smear in 9 cases (4.5%). No significant difference in the unsatisfactory smears was observed between those two groups. The positive rate of diagnosis with CS smears was 60.0% (42/70) and that of TLC was 81.6% (164/201), with a significant difference (P < 0.01). The sensitivity of CS and TLC was 68.9% and 87.7%, respectively (P < 0.01). The sensitivity of both FNA and frozen section diagnosis in 20 cases was 90.0%, respectively, but that of FNA combined with frozen section diagnosis was 95.0%. 9 cancer cases diagnosed by pathology were initially negative by cytology, but adenocarcinoma cells were found in 7 cases of them by the second time cytology examination.

CONCLUSIONThe positive rate is high in TLC smears, and unsatisfactory rate is low. TLC smears are one of the best methods in intraoperative confirmation of pancreatic cancer. The use of FNA smears combined with frozen section biopsy can further improve the sensitivity of diagnosis.