Brush cytology in the diagnosis of colonic neoplasms.
During a three-year period (1986-1988), 234 colonic brush specimens were received in the authors' laboratory. Nine samples (4%) were deemed unsatisfactory for evaluation because of inadequate cellularity and/or poor fixation. In 11 cases concomitant or follow-up histologic specimens were not available. The remaining 214 specimens included 82 malignant neoplasms, 88 neoplastic polyps (adenomas), and 44 nonneoplastic lesions. Sixty-seven (82%) of malignant neoplasms were correctly diagnosed by brush cytology. Three cases of adenoma with severe dysplasia or in situ carcinoma were diagnosed as adenocarcinoma by cytology. No false-positive diagnoses were made of nonneoplastic lesions. Brush cytology was found to be a more sensitive technique in the diagnosis of colon cancer than endoscopic biopsy (82% and 74% sensitivity, respectively). The combination of the two techniques increased the sensitivity to 90% and improved the overall accuracy of the test. Seventy-one (82%) of the colonic adenomas were correctly diagnosed by cytology. Brush cytology is a convenient, safe, and accurate technique which should be used concurrently with endoscopic biopsy or polypectomy.
Department of Pathology and Cell Biology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
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Ehya
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O'Hara
D000236:Adenoma / Q000175:diagnosis; D001706:Biopsy / Q000379:methods; D002278:Carcinoma in Situ / Q000175:diagnosis; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D003111:Colonic Polyps / Q000175:diagnosis; D003581:Cytodiagnosis / Q000379:methods; D004848:Epithelium / Q000473:pathology; D006801:Humans; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies