Preventing malignant-cell transfer during endoscopic brush cytology

Area of Science:

• Gastroenterology
• Cytopathology
• Medical Device Sterilization

Background:

• Cytology brushes are used for gastric biopsies during endoscopy.
• Reusable cytology brushes may pose a risk of malignant cell transfer.
• False positive cytology reports can impact patient diagnosis and treatment.

Purpose of the Study:

• To investigate the risk of malignant cell transfer via reusable cytology brushes.
• To evaluate the effectiveness of different cleaning methods for cytology brushes.
• To assess the implications for diagnostic accuracy in gastric carcinoma detection.

Main Methods:

• Examination of cytology brushes from patients with gastric carcinoma.
• Testing the efficacy of autoclaving, chlorhexidine, and pancreatin for cell eradication.
• Analysis of false positive cytology reports potentially linked to brush contamination.

Main Results:

• Malignant cells were identified on 7 out of 24 examined cytology brushes.
• Autoclaving for 15 minutes effectively eradicated malignant cells.
• Chlorhexidine and pancreatin cleaning methods were insufficient for cell removal.

Conclusions:

• Reusable cytology brushes can harbor malignant cells, leading to false positive results.
• Autoclaving is a validated method for sterilizing cytology brushes.
• While non-disposable brushes offer advantages, their reusability necessitates stringent sterilization protocols to prevent cross-contamination.