Brush Cytology for the Diagnosis of Colorectal Cancer

Brouwer, Richard; Macdonald, Alistair; Matthews, Ronnie; Gunn, James; Monson, J. R. T.; Hartley, John E.

doi:10.1007/dcr.0b013e3181a0ad44

Cited by 18 publications

(19 citation statements)

References 11 publications

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“…In contrast, in our study, sensitivity and specificity were 96 and 63.2% respectively, PPV 91.1, and NPV 80%; the specificity was low because adenomas, which are not malignant but dysplastic nonetheless, were considered malignant in our observation. In the study by Brouwer et al [11], adenomas and inflammatory conditions like ulcerative colitis were not compared with carcinomas. Emulating their study methods, if we grouped adenomas and malignancies under the “neoplastic” rubric, we too would obtain sensitivity and specificity of 94 and 94.12%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Cytology of adenocarcinoma has been evaluated extensively since the advent of fiber optic endoscopy, bringing to light numerous diagnostic pitfalls [10]. Brouwer et al [11] proposed that the diagnostic reliability of brush cytology is equivalent to that of biopsy. They compared brush cytology with histopathology of resected specimens of the same colonic cancer that were assessed as malignant on endoscopy alone.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, if normal mucosa from the edge bearing benign cells largely overwhelm the malignant ones, pathologists would feel uncertain about delivering a malignant diagnosis. While sampling, the putative lesion may be stenotic, or else lie just past a mucosal fold or beyond some colonic flexure [11]. Sometimes, the subepithelial invading front of a cancer may push and heap up normal mucosal epithelium, effecting additional sampling difficulty [10].…”

Section: Discussionmentioning

confidence: 99%

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The Role of Crush Cytology in the Diagnosis of Large-Intestine Lesions with Correlation on Histopathology

Saha²,

Yadav³

et al. 2018

Acta Cytologica

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Objective: To study the efficacy of colonoscopic crush cytology as a convenient and near-accurate method to evaluate colonic neoplasms. Study Design: Retrospective and cross-sectional. The original cytologic diagnoses were correlated with a histology report on 100 cases sent to the cytology laboratory over 2 years. Results: Of the 100 cases, 25 were nonmalignant. Of the 75 malignant lesions, 72 could be identified as positive for malignancy on cytology. The false-positives consisted of 6 adenomas and 1 case of ulcerative colitis. Thus, sensitivity and specificity of cytology are 96 and 63.2%, respectively. Of the 6 adenomas diagnosed as malignant, 4 showed high-grade dysplasia, and the other 2 showed superficial ulceration with low-grade dysplasia on histopathology. The ulcerative colitis case showed widespread ulcers and regenerative/reparative features on biopsy. The 3 adenocarcinomas diagnosed s benign on cytology showed an occasional malignant cell with thickened nuclear borders and prominent central nucleoli. Conclusions: With careful attention to the cytomorphology, coupled with good clinical and endoscopic correlation, crush cytology of the large intestine is a reliable diagnostic tool. It categorizes lesions as malignant and benign with a high sensitivity, positive predictive value, and negative predictive value. Adenomas and reparative/regenerative changes seen in inflammatory bowel disease are major pitfalls in the cytology diagnosis of malignancy that may be averted by informing the endoscopic findings and clinical history. Cytology diagnosis saves time and gives proper feedback to the gastroenterologist.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Role of Crush Cytology in the Diagnosis of Large-Intestine Lesions with Correlation on Histopathology

Saha²,

Yadav³

et al. 2018

Acta Cytologica

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“…For the last 15 years, we have found only four papers on evaluation of cytological diagnostics of the lower gastrointestinal (GI) tract by brush cytology 8,12,13,18 .…”

Section: Introductionmentioning

confidence: 99%

The value of brush cytology and biopsy for the diagnosis of colorectal cancer

et al. 2017

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Background/Aim. Although it is well-known the high sensitivity of brush cytology for the diagnosis of colorectal adenocarcinoma, this kind of diagnostics is not routinely used, and for the past years it has even been declining. The purpose of this study was to evaluate the value of brush cytology for the diagnosis of colorectal carcinoma, by comparison the results of brush cytology and biopsy, and then the results of both diagnostic methods with the final patohistological diagnosis of colorectal resection. Methods. This retrospective study included 173 patients with brush cytology of colorectal region during colonoscopy. In 166 patients concomitant biopsy specimens were obtained, and in 116 of them resection of the intestine as well. A total of the 106 patients underwent to all three diagnostic procedures. Results. Out of 166 patients who went through both brush cytology and biopsy, the congruent diagnosis was made in 129 (77.7%) patients: in 109 (65.7%) adenocarcinoma was diagnosed, which was confirmed after the resection of the intestine in 75 of the patients, and in 14 (8.4%) benign lesion, so there was no need for resection of the intestine. In 6 (3.6%) of the patients, both cytology and biopsy were negative, but the resected specimen was malignant. In 10 of the patients with malignant cytology in whom biopsy was not done, resection of the intestine confirmed malignancy. The sensitivity of detecting malignancy by brush cytology and biopsy were 87.9% and 78.3%, respectively (but this difference was not statistically significant, p = 0.083). Both methods had specificity and positive predictive values 100%. Negative predictive values for cytology and biopsy were 50% and 37.8%, respectively. The accuracy of cytology and biopsy was 89.2% and 80.8%, respectively. The combination of the results of brush cytology and biopsy increased the sensitivity of preoperative diagnostics to 94.8% which was significantly higher than sensitivity of biopsy (p < 0.001), but not than sensitivity of cytology (p = 0.102). Conclusion. Brush cytology could be a routine method, along with biopsy, in the diagnosis of colorectal malignancy. Both methods have comparable both sensitivity and accuracy, and its combination increases sensitivity of preoperative diagnostics of colorectal adenocarcinoma, which gives opportunity to better estimation of further diagnostic and therapeutic approach.

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“…Cytology of tissue biopsies has been applied for the diagnosis of GI malignancy. In humans, a good correlation between cytology and histopathology specimens sampled with gastroduodenoscopy has been observed for various tumor types and several studies have demonstrated that the diagnostic yield of endoscopy can be increased if both modalities are combined (3,5,19,20,23). Few studies investigated cytology of endoscopy-derived samples for the detection of GI neoplasia in small animals (11,12).…”

Section: Introductionmentioning

confidence: 99%

Cytology of endoscopically obtained biopsies for the diagnosis of chronic intestinal diseases in cats

Mangelsdorf¹,

Teske²,

Bomhard³

et al. 2015

Tierarztl Prax Ausg K

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Brush Cytology for the Diagnosis of Colorectal Cancer

Abstract: Brush cytology is as accurate as endoscopic biopsy for the diagnosis of colorectal cancer, and combining these two diagnostic modalities resulted in a significant improvement in the definitive diagnosis of cancer, which might reduce the need for further biopsy.

Cited by 18 publications

References 11 publications

The Role of Crush Cytology in the Diagnosis of Large-Intestine Lesions with Correlation on Histopathology

The Role of Crush Cytology in the Diagnosis of Large-Intestine Lesions with Correlation on Histopathology

The value of brush cytology and biopsy for the diagnosis of colorectal cancer

Cytology of endoscopically obtained biopsies for the diagnosis of chronic intestinal diseases in cats

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