Diagnostic accuracy of endoscopic brush cytology in malignancies of upper gastrointestinal tract: A prospective study of 251 patients in North India.

Objective: To find the spectrum and frequency of upper gastrointestinal malignancies and diagnostic accuracy of endoscopic brush cytology in their diagnosis.

Methods: This study was a prospective study carried out on 251 patients over 1-year in the Department of Pathology. Brushing material was smeared directly on to at least two clean glass slides and was stained with May-Grunwald-Giemsa stain. The endoscopic biopsies were examined grossly and were fixed in 10% formalin, processed, and stained with hematoxylin and eosin stain.

Results: The age range of the patients varied from 8 to 90 years, with the mean being 56 years. Male to female ratio was 2.5:1. On brush cytology, out of 251 cases, 110 had benign lesions and 97 had malignant lesions. Forty-four samples were considered suspicious of malignancy. On histopathology, benign lesions were present in 105 patients while malignant lesions were seen in 139 patients. In seven cases, results were inconclusive due to inadequate/superficial biopsy. Methods: Statistical analysis revealed the overall sensitivity of upper gastrointestinal brush cytology as 83.45% and specificity 80.95%. The accuracy of brush cytology came out to be 82.37% in upper gastrointestinal tract.

Conclusions: Brush cytology is a reliable, safe, inexpensive, and rapid method of diagnosing upper gastrointestinal lesions. Although endoscopic biopsies are established gold standard for diagnosing gastrointestinal malignancy, use of both biopsy and brushing together increases the diagnostic accuracy.