A new device for abrasive cytology sampling during upper gastrointestinal endoscopy: Experience in infectious and neoplastic diseases

Background and Study Aims: The increase in infectious diseases of the gastr ointestinal tract related to immunosuppression is becoming an important top ic for the endoscopist. To improve the diagnostic efficacy of tissue acquis ition while at the same time restricting costs, we have developed a new dev ice for obtaining material from the upper gastrointestinal tract that can a lso be used in the diagnosis of neoplastic disease. Patients and Methods: A total of 90 patients mere examined and assigned to two groups according to indications. Group A consisted of 53 symptomatic pa tients with positive human immunodeficiency virus (HIV) serology with a sus picion of gastrointestinal infection. Group B included 37 patients in whom there was an endoscopic suspicion of neoplasia in the upper gastrointestina l tract. Cell fragments for cytological study mere obtained using a device introduced through the endoscopic instrumentation channel (abrasive cytolog y). Different staining methods were used to isolate bacteria or diagnose tu mors from cell fragments. The findings were compared with those obtained fr om conventional bioptic histology. Results: Potentially responsible pathogens were isolated in 48 of the 53 pa tients in Group A, while bioptic histology provided a diagnosis in only 32 patients. In the 37 patients in group B, the cytological diagnosis matched the histological results. The costs of this new technique are similar to th ose for conventional cytological staining, and the time from sampling to ob taining a final diagnosis is less than one hour. Conclusions: This new device provides a fast and low-cost method of isolati ng pathogens and obtaining cell fragments from the gastrointestinal mucosa during routine upper gastrointestinal endoscopy.