title: Serial fine needle cytology in the diagnosis of esophageal cancer.
abstract: OBJECTIVE
  To describe a method of registering local spread of cancer in the esophageal wall through serial endoscopic fine needle aspiration (FNA), to evaluate FNA as a diagnostic tool as compared to histologic biopsies and brush cytology, and to investigate cytologic appearances of aspirates and correlate them with survival
  
  
  METHODS
  Fifty-two patients with esophageal cancer were investigated with serial FNA every second centimeter from the upper esophageal sphincter aborally down to the level of macroscopic tumor. Histologic biopsies and brush cytologies were then performed.
  
  
  RESULTS
  Of investigated cases, 33% showed malignant or suspect malignant cells from macroscopic tumor, at > or = 4 cm orally, as did 3 of 12 patients at 14 cm. FNA was more sensitive than brush cytology in establishing the diagnosis. A high ratio between the numbers of benign and malignant cells in aspirates from gross tumor tissue correlated with shorter survival (P < .03).
  
  
  CONCLUSIONS
  Serial FNA can demonstrate local microscopic tumor spread in the wall of the esophagus in vivo in esophageal cancer patients. FNA is also a useful adjunct in establishing the diagnosis. Finally, evaluations of tumor cytology may have prognostic value.
authors.affiliation: Department of Surgery, Karolinska Institutet, Danderyd Hospital, S-182 88 Danderyd, Sweden. stockeld@ebox.tninet.se
authors.forename: Dag
authors.initials: D
authors.lastname: Stockeld
authors.forename: Henrik
authors.initials: H
authors.lastname: Ingelman-Sundberg
authors.forename: Lars
authors.initials: L
authors.lastname: Granström
authors.forename: Jan
authors.initials: J
authors.lastname: Fagerberg
authors.forename: Lars
authors.initials: L
authors.lastname: Backman
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000556:secondary; D001706:Biopsy; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity