Esophageal Cytology Sponge Diagnostic Test Results in Kenyatta National Referral Hospital, Kenya

Abstract

Objective: To describe the cytological findings of the esophagus using sponge cytology as a triage test in patients referred for esophageal endoscopy at Kenyatta National Hospital. Study Design: A cross-sectional descriptive study was undertaken to obtain specimens from the esophagus for cytological evaluation using a sponge. The cellular yield and pattern of esophageal cytological findings was described by cytopathologists using the Bethesda system. The cytological findings were compared with endoscopy findings and whenever possible with biopsy results. Results: All the participants (100%) swallowed the encapsulated sponge successfully and had smears with satisfactory material for evaluation. Negative smears for intraepithelial lesion or malignancy were the most common (86.6%), with intestinal metaplasia reported in 10% of all patients, high-grade squamous intraepithelial lesions in 1.7% and squamous cell carcinoma in 1.7%. There was good agreement between endoscopic and cytological findings. Conclusion: Sponge cytology is a simple and inexpensive technique which seems to have promising results as a primary test as well as a triage test whenever there is any suspicion of an esophageal lesion, especially in clinical settings where endoscopic facilities and medical professionals are not available. Hence, further evaluation using a larger sample size is recommended.

Minimally invasive esophageal sponge cytology sampling is feasible in a Tanzanian community setting

“…We successfully conducted a Cytosponge feasibility study in Tanzania An unspecified number of patients with dysphagia were unable to swallow, but the device was successful in 60 endoscopy referrals and moderate to good agreement was found with endoscopy findings, that is, two histologically confirmed ESCC cases were also detected by the Oesotoest. 22 Our 100% swallow success and high acceptability in Tanzanian are similarly encouraging. A notable feature of previous studies is sample preparation, whereby sponges were smeared onto slides and spray-fixed, which gives a lower cell yield than FFPE clots.…”

“…A low proportion of swallowing failures (<2%) and suboptimal cellularity (~3%) were reported 20,21 . A later study 22 evaluated the Oesotest as a clinical triage in Nairobi, Kenya. An unspecified number of patients with dysphagia were unable to swallow, but the device was successful in 60 endoscopy referrals and moderate to good agreement was found with endoscopy findings, that is, two histologically confirmed ESCC cases were also detected by the Oesotoest 22 .…”

“…A later study 22 evaluated the Oesotest as a clinical triage in Nairobi, Kenya. An unspecified number of patients with dysphagia were unable to swallow, but the device was successful in 60 endoscopy referrals and moderate to good agreement was found with endoscopy findings, that is, two histologically confirmed ESCC cases were also detected by the Oesotoest 22 . Our 100% swallow success and high acceptability in Tanzanian are similarly encouraging.…”

“…A low proportion of swallowing failures (<2%) and suboptimal cellularity (~3%) were reported 20,21. A later study22 evaluated the Oesotest as a clinical triage in Nairobi, Kenya.…”

Impact of Brush Cytology Analysis for the Diagnosis of Esophageal Squamous Cell Carcinoma: The Quality of Liquid-Based Preparation of Cytological Slides

“…Based on this, esophageal cytological samples combined with molecular methods should be considered as a promising alternative for targets with therapeutic intent [22]. However, currently, this matter has only been dismally explored.…”