Biopsy and cytology in the diagnosis of early gastric cancer: 10-year experience with direct vision techniques at a Japanese institution.

The results of direct vision biopsy and cytology for the diagnosis of early gastric cancer during the periods from 1964 to 1969 and from 1970 to 1974 were compared. From 1964 to 1969 the diagnostic accuracy of gastric biopsy was 94.7% at the initial examination and 97.3% in the final diagnosis, while washing cytology under direct vision gave a diagnostic accuracy of 83.0% at the first washing and 93.3% in the final cytologic diagnosis. Because of such a high yield of gastric biopsy, it was the procedure of the first choice from 1970 to 1974, giving a diagnostic accuracy of 96.7% at the initial examination and 99.4% in the final biopsy diagnosis with only one suspicious case. The cytologic examination by brushing has, therefore, become supplementary to biopsy in cases where a stenosis proximal to a tumor obscures the definitive tissue.