Evaluation of endoscopic brush and biopsy touch smear cytology and biopsy histology in the diagnosis of carcinoma of the lower oesophagus and cardia.

A four-year prospective study of endoscopic cytology and histology was carried out on 64 patients suspected of having a malignant lesion at the junction of the lower oesophagus and cardia. The final diagnosis was malignant in 18 and benign in 46 cases. Biopsy touch smear cytology was the most accurate technique with a sensitivity of 100% compared with 82% for brush cytology and 89% for biopsy histology. There was one false positive endoscopic histology report, but no false positive cytology result. Biopsy touch smear cytology is at present a method little used in the digestive tract. This study demonstrates its value in the diagnostically difficult area of the gastro-oesophageal junction.