Endoscopic techniques in the diagnosis of upper gastrointestinal tract malignancies - A comparison

OBJECTIVE: To perform a comparative evaluation of various endoscopic techniques in the diagnosis of upper gastrointestinal tract malignancies. STUDY DESIGN: Thirty cases of suspected malignancy involving the upper gastrointestinal tract were studied. In all 30 cases, four endoscopic cytology techniques (brushing before biopsy, brushing after biopsy, fine needle aspiration cytology [FNAC] and suction cytology) were evaluated and correlated with histology by forceps biopsy. All the cytologic techniques were used and forceps biopsy carried out in a single sifting, but the forceps biopsy was repeated in 4 of 30 cases. RESULTS: The respective positive yields of brushing before biopsy, brushing after biopsy, FNAC, suction cytology and forceps biopsy were 80.0%, 86.6%, 83.3%, 76.6% and 90.0%. When two cytologic techniques were combined, 100% accuracy was obtained by brushing after biopsy and FNAC and brushing before biopsy and suction cytology. CONCLUSION: Brushing cytology is a sensitive diagnostic test, and the combined use of biopsy and brushing offers the highest probability of identifying malignancy.