A prospective comparison of brush cytology before and after biopsy in diagnosis of gastric malignancies

Gastric malignancies are the third most common causes of cancer-related death in the world. Here, we aimed to compare brush cytology before and after biopsy in the diagnosis of gastric malignancies. This prospective study included 74 cases referred to endoscopy clinic for suspected gastric lesions during 1 year. In 38 cases, brush cytology was done before and in 36 cases it was done after biopsy. All the cytology and biopsy slides were randomly coded and reviewed by a pathologist blindly without any knowledge of the surgical pathology result or clinical data of the patients. Diagnostic accuracy of brush cytology before biopsy was significantly higher than after biopsy (86.8 vs. 52.8 %, P = 0.003). This accuracy did not show any relations to the site of the lesion or endoscopic appearance of it (P > 0.05). We suggest endoscopic biopsy and cytology to be done together, especially in highly suspected cases to malignancy and also our study showed that it is better to do brushing before tissue biopsy.