Accuracy of oesophageal brush cytology: Results of a prospective study and multicentre slide exchange

The value of brush cytology has been assessed in the diagnosis of 101 oesophageal strictures in a department with no previous experience of oesophageal cytology. Cytological specimens obtained using a brush gave a correct diagnosis in 86 per cent of 36 malignant strictures with only 2 false negatives; when combined with biopsy, accuracy rose to 92 per cent. Of 65 benign strictures examined there were 3 false positives. In a series of test slides sent to 11 other hospitals the average false negative diagnosis was 4 per cent and false positive 3 per cent. Four of the centres had little previous experience and only two had extensive experience in oesophageal cytology. Therefore, brush cytology as a proved aid to the accurate diagnosis of oesophageal malignancy is within the capability of most pathology departments and should be used more widely.