Brush cytology: an adjunct to diagnostic upper GI endoscopy

Area of Science:

• Pediatric Gastroenterology
• Infectious Diseases
• Diagnostic Endoscopy

Background:

• Upper GI endoscopy is crucial for diagnosing pediatric gastrointestinal issues.
• Helicobacter pylori (Hp) and Giardia lamblia (Glt) are common pathogens affecting children.
• Routine endoscopic grasp biopsy (EGB) has limitations in pathogen detection.

Purpose of the Study:

• To evaluate the efficacy of endoscopic brush cytology (EBC) in detecting Hp and Glt in children.
• To compare the diagnostic yield of EBC with routine EGB.
• To assess the safety and impact of EBC on endoscopic procedures.

Main Methods:

• A prospective hospital-based study involving 170 children (1-13 years) undergoing upper GI endoscopy.
• EBC performed using a sheathed cytology brush for antral and duodenal brushings.
• Comparison of EBC results with routine endoscopic grasp biopsies (EGB).
• Giemsa and Hematoxylin & Eosin stains used for microscopic examination.

Main Results:

• Hp detected in 20.4% and Glt in 8.2% of children.
• EBC showed higher detection rates for Hp (65.8%) than EGB (58.5%).
• EBC demonstrated significantly higher detection rates for Glt (95%) compared to EGB (60%).
• No complications were reported with EBC, and procedure time was not significantly increased.

Conclusions:

• Endoscopic brush cytology is a safe and valuable adjunct to routine endoscopic grasp biopsy for diagnosing Hp and Glt in children.
• EBC significantly improves the detection of Giardia lamblia, aiding in timely and appropriate patient management.
• Incorporating EBC enhances the overall diagnostic utility of upper GI endoscopy in pediatric patients.