Carcinoma of the esophagus and cardia: diagnostic evaluation in 113 cases.

Fiberoptic endoscopy with directed biopsy and brush cytology was used to diagnose 73 patients with squamous carcinoma of the esophagus and 40 adenocarcinomas of the gastric fundus invading the lower esophagus. Over-all accuracy of histologic diagnosis in the esophagus was 95.8 per cent and in the cardia, 97.5 per cent. Multiple biopsies (6 to 8) and brush cytology complemented one another in providing a high index of reliable histologic diagnoses. There were no complications. Endoscopy with the fiberoptic scope as now performed is well tolerated and accurate. It appears to be the most reliable means of diagnosis in cancer of the esophagus and cardia and should be performed routinely in all patients with symptoms referable to the esophagus.