Abstract
A prospective study was carried out on 120 patients undergoing endoscopic evaluation to assess the diagnostic utility of endoscopic biopsy and brush cytology in the diagnosis of upper gastrointestinal neoplasm. The findings of brush cytology were compared with that of endoscopic biopsy and/or excision biopsy. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of brush cytology in diagnosing upper gastrointestinal malignancies are 85.7%, 98.4%, 98%, 88.7% & 92.5% respectively and for endoscopic biopsy the values are 89.3%, 98.4%, 98%, 91.3% & 94.2% respectively. Whereas when the brush cytology and biopsy findings were taken together the diagnostic value was significantly improved with 98%, 96.8%, 96.5%, 98.4% & 97.5% respectively. Hence brush cytology is a useful adjunct in the diagnosis of upper gastrointestinal neoplasm and should be considered as a routine method in combination with endoscopic biopsy. Combined use of endoscopic biopsy and brush cytology together increases the sensitivity, negative predictive value and accuracy of diagnosis of malignancy.
Keywords: Brush cytology, endoscopic biopsy, upper gastrointestinal neoplasm.
References
- Torre LA, Siegel RL, Ward EM, Jemal A. Global Cancer Incidence and Mortality Rates and Trends—An Update. Cancer Epidemiol Prev Biomark. 2016 Jan 1;25(1):16–27.
- Three Year Report of PBCR 2012-2014 [Internet]. [cited 2017 Dec 30]. Available from: http://www.ncrpindia.org/ALL_NCRP_REPORTS/PBCR_REPORT_2012_2014/index.htm
- Dikshit RP, Mathur G, Mhatre S, Yeole BB. Epidemiological review of gastric cancer in India. Indian J Med Paediatr Oncol Off J Indian Soc Med Paediatr Oncol. 2011 Jan;32(1):3–11.
- Onodera H, Tokunaga A, Yoshiyuki T, Kiyama T, Kato S, Matsukura N, et al. Surgical outcome of 483 patients with early gastric cancer: prognosis, postoperative morbidity and mortality, and gastric remnant cancer. Hepatogastroent-erology. 2004 Feb;51(55):82–5.
- D’Amico TA. Outcomes After Surgery for Esophageal Cancer. Gastrointest Cancer Res GCR. 2007;1(5):188–96.
- Geramizadeh B, Shafiee A, Saberfirruzi M, Kumar PK, Shaheem A. Brush cytology of gastric malignancies. Acta Cytol. 2002 Aug;46(4):693–6.
- Gastroenterology BPGL and BS of. Value of biopsy and brush cytology in the diagnosis of gastric cancer. Shanghai Gastrointestinal Endoscopy Cooperative Group, People’s Republic of China. Gut. 1982 Sep 1;23(9):774–6.
- Malhotra V, Puri R, Chinna RS, Chawla LS, Sabharwal BD. Endoscopic Techniques in the Diagnosis of Upper Gastrointestinal Tract Malignancies. Acta Cytol. 1996;40(5):929–32.
- Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO classification of tumours of the digestive system. 4th edition. WHO. International agency for research on cancer, Lyon. 2010.
- Schlemper RJ, Riddell RH, Kato Y, Borchard F, Cooper HS, Dawsey SM, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut. 2000 Aug;47(2):251–5.
- Williams DG, Truelove SC, Gear MW, Massarella GR, Fitzgerald NW. Gastroscopy with biopsy and cytological sampling under direct vision. Br Med J. 1968 Mar 2;1(5591):535–9.
- Moreno-Otero R, Marrón C, Cantero J, Pajares JM, Martinez-Raposo A. Endoscopic biopsy and cytology in the diagnosis of malignant gastric ulcers. Diagn Cytopathol. 1989;5(4):366–70.
- Geramizadeh B, Shafiee A, Saberfirruzi M, Kumar PK, Shaheem A. Brush cytology of gastric malignancies. Acta Cytol. 2002 Aug;46(4):693–6.
- Vidyavathi K, Harendrakumar ML, Kumar YL. Correlation of endoscopic brush cytology with biopsy in diagnosis of upper gastrointestinal neoplasms. Indian J Pathol Microbiol. 2008 Oct 1;51(4):489.
- O’Donoghue JM, Horgan PG, O’Donohoe MK, Byrne J, O’Hanlon DM, McGuire M, et al. Adjunctive endoscopic brush cytology in the detection of upper gastrointestinal malignancy. Acta Cytol. 1995 Feb;39(1):28–34.
- Peng H-Q, Halsey K, Sun C-CJ, Manucha V, Nugent S, Rodgers WH, et al. Clinical utility of postchemoradiation endoscopic brush cytology and biopsy in predicting residual esophageal adenocarcinoma. Cancer Cytopathol. 2009 Dec 25;117(6):463–72.
- Bemvenuti GA, Hattori K, Levin B, Kirsner JB, Reilly RW. Endoscopic sampling for tissue diagnosis in gastrointestinal malignancy. Gastrointest Endosc. 1975 May 1;21(4):159–61.
- Qizilbash AH, Castelli M, Kowalski MA, Churly A. Endoscopic brush cytology and biopsy in the diagnosis of cancer of the upper gastrointestinal tract. Acta Cytol. 1980;24(4):313–8.
- Gupta RK, Rogers KE. Endoscopic cytology and biopsy in the diagnosis of gastroesophageal malignancy. Acta Cytol. 1983 Feb;27(1):17–22.
- Batra M, Handa U, Mohan H, Sachdev A. Comparison of cytohistologic techniques in diagnosis of gastroesophageal malig-nancy. Acta Cytol. 2008 Feb;52(1):77–82.
Corresponding Author
Dr Rajesh Kumar Bhola
Assistant Professor, Department of Pathology, IMS & SUM Hospital, Sector 8, Kalinga Nagar,
Bhubaneswar, Odisha, India – 751003
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mob: +919776304199
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.27
