Endoscopy 2019; 51(04): S237
DOI: 10.1055/s-0039-1681882
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Esophagus ePosters
Georg Thieme Verlag KG Stuttgart · New York

NBI GUIDED CRUSH CYTOLOGY COMPARED TO HISTOPATHOLOGY – EARLY DIAGNOSIS & FASTER TREATMENT INITIATION

P Desai
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
,
M Kabrawala
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
,
R Mehta
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
,
S Nandwani
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
,
C Patel
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
,
P Kalra
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
,
R Prajapati
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
,
N Patel
1   Endoscopy, Surat Institute of Digestive Sciences, Surat, India
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

To Prove the Utility of Crush Cytology as compared to standard histopathology.

Methods:

Crush cytology for gastrointestinal (GI) lesions is not studied much. We studied utility of crush cytology in diagnosis of GI lesions compared to conventional histopatholgy. 94 suspected cases of malignancy of esophagus, stomach, ampulla and colorectum, undergoing endoscopy from August 2018 to November 2018 were included in the study. For any tumor, an area was targeted for biopsy using NBI criteria, first 2 biopsies taken on a slide, crush smears made, stained with H&E and studied. then Correlation done with conventional histopathology from remaining bits. Diagnostic values, accuracy, sensitivity, specificity, and positive and negative predictive values calculated.

Results:

There were 72 cases of histologically confirmed carcinomas and 65 cases were positive for carcinoma by crush smear cytology. Thus, the diagnostic performance of crush cytology and histopathology was 90.3% vs. 100%; p=> 0.05 which revealed no significant difference between two tests. Male/female ratio of 2.6:1 and mean age of 60.3 years;Incidence of carcinomas was highest in seventh decade, with 36.6% cases. Most common site was colorectal (52.4%) followed by esophagus (22.9%), stomach (17.1%), ampulla (4.3%) and GE junction with 2.8% cases each. Most common histologic types of colorectal and gastric malignancy were well-differentiated adenocarcinoma (83.8% & 69.2%) and poorly differentiated adenocarcinoma (2.7% & 30.8%), respectively. Squamous cell carcinoma (18.8%) was the most common malignancy of esophagus. Crush smears were not conclusive in 7 cases i.e they showed high grade dysplasia and final biopsy was malignant. Sensitivity of crush cytology was 79.5%, specificity 85.5%, PPV 90.3%, and NPV of 19.8%. Diagnostic accuracy 82.5%.

Conclusions:

Crush cytology is Easy and rapidly performed technique. The diagnostic yield is very high. It is comparable to histopathology. Final pathology certain in > 90%. Treatment/surgery can be initiated faster without awaiting HPE report.