Comparison between Brush Cytology before .and after and after Biopsy in the Diagnosis of Gastric Malignancies

Objectives: To compare doing brush cytology before and after biopsy. in the diagnosis of gastric malignancies Study Design: This prospective study included 7 4 cases referred to endoscopy clinic for suspected gastric lesions during a year (2013-2014). In 38 cases brush 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 i.e. without any knowledge of the surgical pathology result or clinical data of the patient . Results: Diagnostic accuracy of brush cytology before biopsy was significantly higher than after biopsy (86.8% vs. 52.8%, P value<0.003) This accuracy didn't show any relation to the site of the lesion or endoscopic appearance of it . Conclusion: 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 .