SUMMARY

Two series of patients have been studied with a view to evaluating the place of cytology in current methods of gastric cancer diagnosis. Series A (299 gastric cancer patients) was analysed retrospectively, and clear evidence was found that radiological methods, although adequate for the recognition of gross lesions, were poor for demonstrating the immediate, correct diagnosis of the exact pathology present. Specific difficulties were caused by small ulcerated lesions in the lower stomach and gastric curvatures. Series B (149 patients) studied prospectively showed that gastric cytology, added to radiological studies, greatly improved diagnostic accuracy. Where clean washings were obtainable (non-pyloric disease), 94-5 per cent correct results were obtained by cytology alone. The complementary nature of cell-diagnosis was confirmed when it was shown to be most accurate where X-rays were weakest, particularly in small, ulcerated lesions in the greater or lesser curvatures of the stomach. Cytology of gastric washings is needed because stomach cancer is still poorly diagnosed by purely macroscopical methods