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


Endoscopy. 1999 Jun;31(5):348-51. Unique Identifier : AIDSLINE

BACKGROUND AND STUDY AIMS: The increase in infectious diseases of the gastrointestinal tract related to immunosuppression is becoming an important topic for the endoscopist. To improve the diagnostic efficacy of tissue acquisition while at the same time restricting costs, we have developed a new device for obtaining material from the upper gastrointestinal tract that can also be used in the diagnosis of neoplastic disease. PATIENTS AND METHODS: A total of 90 patients were examined and assigned to two groups according to indications. Group A consisted of 53 symptomatic patients with positive human immunodeficiency virus (HIV) serology with a suspicion of gastrointestinal infection. Group B included 37 patients in whom there was an endoscopic suspicion of neoplasia in the upper gastrointestinal tract. Cell fragments for cytological study were obtained using a device introduced through the endoscopic instrumentation channel (abrasive cytology). Different staining methods were used to isolate bacteria or diagnose tumors from cell fragments. The findings were compared with those obtained from conventional bioptic histology. RESULTS: Potentially responsible pathogens were isolated in 48 of the 53 patients 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 those for conventional cytological staining, and the time from sampling to obtaining a final diagnosis is less than one hour. CONCLUSIONS: This new device provides a fast and low-cost method of isolating pathogens and obtaining cell fragments from the gastrointestinal mucosa during routine upper gastrointestinal endoscopy.

JOURNAL ARTICLE Adolescence Adult Aged Aged, 80 and over AIDS-Related Opportunistic Infections/MICROBIOLOGY/PATHOLOGY Bacterial Infections/MICROBIOLOGY/*PATHOLOGY Biopsy/ECONOMICS/INSTRUMENTATION Comparative Study Cost-Benefit Analysis Cytological Techniques/ECONOMICS/INSTRUMENTATION Diagnosis, Differential Duodenal Diseases/MICROBIOLOGY/*PATHOLOGY Endoscopy, Digestive System/*INSTRUMENTATION Equipment Design Esophageal Diseases/MICROBIOLOGY/*PATHOLOGY Female Gastrointestinal Neoplasms/*PATHOLOGY Human HIV/IMMUNOLOGY HIV Antibodies/ANALYSIS Intestinal Mucosa/MICROBIOLOGY/*PATHOLOGY Male Middle Age Mycoses/MICROBIOLOGY/PATHOLOGY Reproducibility of Results Stomach Diseases/MICROBIOLOGY/*PATHOLOGY


Information in this article was accurate in November 30, 1999. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.