Adjunctive endoscopic brush cytology in the detection of upper XXXX .

@entity1 @entity3137 @entity344
The role of exfoliative cytology as an adjunct to endoscopic biopsy in the detection of upper @entity344 is controversial insofar as some claim that its use is of little clinical benefit. The role of cytology in the differentiation of benign from @entity3137 in 2,183 consecutive @entity1 who underwent esophagogastroduodenoscopy was examined. Malignancy was confirmed in 394 @entity1 . Both endoscopic biopsy and cytology were positive in 275 of 394 (69.8%) @entity1 . Endoscopic biopsy provided the diagnosis in the presence of negative cytology in 73 of 394 (18.5%) cases, while cytology was positive after a negative biopsy in 36 of 394 (9.2%) @entity1 . Ten of 394 (2.5%) @entity1 were not diagnosed preoperatively using either modality. Endoscopic biopsy yielded a sensitivity of 88.3%, specificity of 99.9%, positive predictive value of 99.7% and negative predictive value of 97.6%. Cytology alone, in contrast, yielded a sensitivity of 79%, specificity of 98.5%, positive predictive value of 92.3% and negative predictive value of 95.6%. With the additional use of cytology, the diagnostic yield was increased from 88.3% to 97.5%. We conclude that upper gastrointestinal exfoliative cytology is a useful adjunct in the investigation of @entity1 with suspicious @entity3137 .
