Diagnostic utility of endoscopic brush cytology in upper gastrointestinal lesions and its correlation with biopsy.

Abstract

Background: The endoscopic examination of upper gastrointestinal lesions is invaluable in the diagnosis of different neoplastic and non neoplastic conditions. Malignancies of upper GIT are one of the leading causes of death worldwide. Early cancer is asymptomatic and highly curable. The advent of the endoscope has greatly facilitated the detection and diagnosis of upper GIT lesions. Brush cytology and biopsy are complementary, and yield is higher when both are employed rather than when one is used. Aim: The aim of this study was to analyze the advantages, utility and limitations of brush cytology in upper GIT lesions. Materials and Methods: 100 cases including neoplastic and non neoplastic lesions, were studied over a period of one year. Endoscopy was done by using flexible video endoscope. Patients with visible mucosal lesions such as ulcers, polypoidal or ulcerative growths in the upper GIT were included. An endoscopic brush followed by biopsy of the lesion was done. The cytological and histopathological findings were compared and the percentage positivity of brush cytology was determined. Results: Patients between 20-80 years age presented with complaints of dysphagia, retrosternal pain, vomiting and loss of weight. The overall adequacy of brush cytology was 100%. Smears were interpreted as inflammatory, fungal infection, dysplastic lesions, suspicious for malignancy and positive for malignancy. Biopsy was available in 67 cases of which cytohistological correlation was there in 61 [ 83.68 %] cases, as the remaining biopsies were inadequate for reporting.. Conclusion: Endoscopic brush cytology is an effective method for evaluation and screening of upper GIT lesions and can be utilized for rapid diagnosis with minimal discomfort to the patient.