A new device for abrasive cytology sampling during upper gastrointestinal endoscopy: experience in infectious and neoplastic diseases.
OBJECTIVE
The increase in infectious diseases of the gastrointestinal tract related to immunosuppression is becoming an important topic for the endoscopist. To improve the diagnostic efficacy of tissue acquisition while at the same time restricting costs, we have developed a new device for obtaining material from the upper gastrointestinal tract that can also be used in the diagnosis of neoplastic disease.


METHODS
A total of 90 patients were examined and assigned to two groups according to indications. Group A consisted of 53 symptomatic patients with positive human immunodeficiency virus (HIV) serology with a suspicion of gastrointestinal infection. Group B included 37 patients in whom there was an endoscopic suspicion of neoplasia in the upper gastrointestinal tract. Cell fragments for cytological study were obtained using a device introduced through the endoscopic instrumentation channel (abrasive cytology). Different staining methods were used to isolate bacteria or diagnose tumors from cell fragments. The findings were compared with those obtained from conventional bioptic histology.


RESULTS
Potentially responsible pathogens were isolated in 48 of the 53 patients in Group A, while bioptic histology provided a diagnosis in only 32 patients. In the 37 patients in group B, the cytological diagnosis matched the histological results. The costs of this new technique are similar to those for conventional cytological staining, and the time from sampling to obtaining a final diagnosis is less than one hour.


CONCLUSIONS
This new device provides a fast and low-cost method of isolating pathogens and obtaining cell fragments from the gastrointestinal mucosa during routine upper gastrointestinal endoscopy.
Casco
C
C
Gastroenterology Service, Diego Paroissien Hospital, La Matanza, Buenos Aires, Argentina.
Martins
D
D
Lettieri
S
S
Rubio
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HW
D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000382:microbiology / Q000473:pathology*; D001706:Biopsy / Q000191:economics / Q000295:instrumentation; D003362:Cost-Benefit Analysis; D003584:Cytological Techniques / Q000191:economics / Q000295:instrumentation; D003937:Diagnosis, Differential; D004378:Duodenal Diseases / Q000382:microbiology / Q000473:pathology*; D016145:Endoscopy, Digestive System / Q000295:instrumentation*; D004867:Equipment Design; D004935:Esophageal Diseases / Q000382:microbiology / Q000473:pathology*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D006678:HIV / Q000276:immunology; D015483:HIV Antibodies / Q000032:analysis; D006801:Humans; D007413:Intestinal Mucosa / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000382:microbiology / Q000473:pathology; D015203:Reproducibility of Results; D013272:Stomach Diseases / Q000382:microbiology / Q000473:pathology*
D015483:HIV Antibodies