[Cancer of the ovary: the usefulness of Cul-de-sac aspiration and the level of carcino-embryonic antigen in the peritoneal fluid]

While it is useful to carry out aspiration from the Pouch of Douglas for screening for cancer of the ovary, the technique is irreplaceable for the follow-up of tumours that have been operated on or irradiated or treated with chemotherapy. We have carried out 1,353 aspirations: 189 of these which were done routinely have been equivocal. 380 aspirations that were carried out because of abnormal symptoms led to the discovery of 26 cancers of which 2 were very early ones. 784 aspirations were carried out for follow-up. There were in all 4.8% blank aspirations, 0.5% false positives and 1.6% false negatives, which is an indication of the reliability of the method so long as certain points in the technique are carefully followed. These figures, which are quoted as a percentage of the total number of aspirations, however, become more important when considered as a percentage of the number of cancers that were diagnosed (5.5% false positive and 18% false negatives). Furthermore, the level of C.E.A. in peritoneal fluid is a method which can be added to cytology in following up the progress of the disease which is not to be dismissed.