Esophageal Exfoliative Cytology Samplers

Sepehr, Alireza; Razavi, Payam; Saidi, Farrokh; Salehian, Pirooz; Rahmani, Mehrangiz; Shamshiri, Ahmadreza

doi:10.1159/000328564

Cited by 13 publications

(8 citation statements)

References 11 publications

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“…The cytology sponges had good cellular yield (satisfactory smears for evaluation) similar to other studies done elsewhere [7,14,15]. However, patients with moderate-to-severe dysphagia could not swallow the encapsulated sponge and hence were excluded from the study.…”

Section: Discussionsupporting

confidence: 65%

“…Also, the 5-year survival rate was 85-90% and the 10-year survival rate was 55.6%, which was achieved subsequent to early surgical interventions [4]. Some studies have shown sponge cytology to be more readily acceptable by patients than the other cytological methods, with a sensitivity of 81-90% and specificity of 92-99% [7,8]. Recent studies have reported low sensitivity and specificity of cytological methods below the acceptable limit for application in mass screening programs.…”

Section: Introductionmentioning

confidence: 99%

“…Inadequate smears have less than 10% of the slide surface covered by squamous cells. Adequate glandular cells have at least two well-preserved and well-visualized clusters, each with at least five glandular cells [7]. …”

Section: Introductionmentioning

confidence: 99%

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

Muriithi¹,

Muchiri²,

Gn³

2014

Acta Cytologica

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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.

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Section: Discussionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

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

Muriithi¹,

Muchiri²,

Gn³

2014

Acta Cytologica

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“…Furthermore, our previous studies have shown that aberrant expression of the MCM proteins is a powerful marker of dysplasia in Barrett's oesopagus (Going et al, 2002). These data suggest that the immunofluorometric Mcm5 test could be further refined for screening of Barrett's oesophagus by employing balloon cytology catheters, increasing the yield of cellular material for biochemical analysis (Liu et al, 1994;Sepehr et al, 2000). The sensitivity and specificity data are strikingly similar when comparing oesophageal cancer with genitourinary tract cancers.…”

Section: Discussionmentioning

confidence: 85%

Diagnosis of oesophageal cancer by detection of minichromosome maintenance 5 protein in gastric aspirates

et al. 2004

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Symptomatic oesophageal cancer is usually advanced and the prognosis poor. Lethality of symptomatic oesophageal cancer has motivated screening for these diseases earlier in their evolution, but reliable methods for early diagnosis remain elusive. We have demonstrated that dysregulated expression of minichromosome maintenance (MCM) proteins 2 -7 is characteristic of early epithelial carcinogenesis, and that these key DNA replication initiation factors can be used as diagnostic markers for cervical and genito-urinary tract cancer. In this study, we investigated whether minichromosome maintenance protein 5 (Mcm5) can be used to detect oesophageal cancer cells in gastric aspirates. Two monoclonal antibodies raised against His-tagged human Mcm5 were used in a timeresolved immunofluorometric assay to measure Mcm5 levels in cells isolated from gastric aspirates of 40 patients undergoing gastroscopy for suspected or known oesophageal carcinoma or symptoms of dyspepsia. The test discriminated with high specificity and sensitivity between patients with and without oesophageal cancer (85% sensitivity (95% confidence interval (CI) ¼ 62 -97%), 85% specificity (CI ¼ 66 -96%)), as demonstrated by the large area under the receiver operating characteristics curve (0.93 (95% CI ¼ 0.85 -0.99)). Elevated levels of Mcm5 in gastric aspirates are highly predictive of oesophageal cancer. This simple test for oesophageal cancer is readily automated with potential applications in primary diagnosis, surveillance and screening.

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“…Sensitivity of endoscopic examination can be increased by use of Lugol's iodine (14). Exfoliative balloon cytology can be used to obtain esophageal cells for evaluation of dysplasia for surveillance in high-risk groups (15). Squamous dysplasia is a histologic lesion confined to epithelium and is characterized by cytologic and architectural abnormalities.…”

Section: Premalignant/precursor Lesionmentioning

confidence: 99%

Pathology of esophageal cancer and Barrett’s esophagus

Jain

Dhingra

2017

Ann. Cardiothorac. Surg.

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Esophageal cancer is a serious malignancy with high mortality. The two common distinctive pathologic subtypes of esophageal cancer are squamous cell carcinoma and adenocarcinoma. These differ with regards to etiology, ethnic distribution, pathogenesis, and location in the esophagus. The precursor lesions are also unique to each subtype. Squamous cell carcinoma is more common in East Asia, is linked to smoking and tobacco use, more commonly involves the middle esophagus, and the precursor lesion is squamous dysplasia.Adenocarcinoma is more common in the United States and certain European countries, associated with obesity and gastroesophageal reflux disease (GERD), more commonly involves the distal esophagus, and the precursor lesion is Barrett's esophagus. Endoscopic surveillance with biopsy evaluation is the standard of care in high-risk groups. Endoscopic ablative therapies for early cancers have lower morbidity than surgery. Despite increased awareness, identification of high-risk groups and endoscopic surveillance, a large proportion of patients present with advanced cancers. Surgery and chemoradiation, either in neo-adjuvant or adjuvant setting, is the usual treatment for patients with advanced but resectable esophageal cancers. The prognosis and further management largely depends upon the pathologic tumor-node-metastasis (TNM) staging provided by the American Joint Committee on Cancer (AJCC) and the International Union against Cancer. Currently, the 7th edition of TNM staging system is being applied for prognostication and this is more focused on pathologic evaluation. Eighth edition of AJCC/UICC TNM staging has been introduced and will be implemented for clinical use in 2018.

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Esophageal Exfoliative Cytology Samplers

Cited by 13 publications

References 11 publications

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

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

Diagnosis of oesophageal cancer by detection of minichromosome maintenance 5 protein in gastric aspirates

Pathology of esophageal cancer and Barrett’s esophagus

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