Brush cytology in the endoscopic diagnosis of benign gastric ulcers. A useful adjunct to biopsy?

A series of 417 endoscopic brush cytology-multiple biopsy specimens from 220 patients with clinically suspected gastritis was studied, with a 6-year follow-up, to find out whether brush cytology and histology combined provided better results than histology alone, in the endoscopic diagnosis of benign gastric ulcer. Each technique yielded the best results in its own field of observation. Cytology was superior to histology in diagnosing inflammatory reactions related to infection. In this series, 35.73% of the inflammatory smears were related to bacteria, 12.23% to fungi, 0.23% to herpes virus, and 0.23% to Giardia lamblia. Cytology also revealed active chronic superficial gastritis (33.57%) in these patients more often than histology (12.23%). Histology, primarily a technique for studying the architecture of the epithelium, found atrophic gastritis in 75.53% of the specimens examined, whereas cytology only identified 48.20%. As these findings show, even though histology is the diagnostic method of choice, whenever circumstances allow, the use of cytology as an adjunct is advantageous and will improve accuracy in the diagnosis of benign gastric ulcer, especially in the presence of inflammation or infection.