Biopsy and brush cytology in the diagnosis of gastric cancer.

In a prospective study the diagnostic value of biopsy and that of brush cytology in the diagnosis of gastric cancer were compared. The patients included in the study were endoscopied because of upper abdominal dyspepsia. When the endoscopic appearance of the mucosa suggested malignancy, and in all cases in which ulcerations were seen, brush cytological smear and at least five biopsies were obtained. The cytology and the biopsy specimens were assessed by two different pathologists in a mutual blind fashion. If the result of the examination suggested or showed the presence of cancer, it was considered positive. The results were evaluated by means of sequential analysis. When 195 examinations had been included in the study, disagreement had occurred in 8 cases, in all of which the biopsy was verified as correct. This difference is significant. In 187 cases the result of the 2 tests were in agreement, but in 3 cases the result of both tests were falsely negative. It was concluded that no diagnostic advantage was gained by the addition of brush cytology to endoscopic biopsy.