ABSTRACT
A retrospective study of oesophageal cytopathology at the Hospital de Clinicas de Porto Alegre (HCPA), RS, Brazil, from 1989 to 1992 was made assess the sensitivity, specificity, predictive values and accuracy of endoscopic cytology and biopsy; and study the correlation between cytopathological and histopathological diagnosis. Specimens from 94 patients were available for review. The final diagnosis was based on surgical pathology and follow up. The 81 patient with cancer of the oesophagus had the following sex distribution: 64 males and 17 females(a 3.7-1 ratio). No tumour was found in 13 patients. The following conclusions were made: (i) there is excellent correlation between cytology and histology in oesophageal lesions sampled by endoscopy; (ii) a correct positive cytologic report was obtained in 77 (95%) of the 81 proven oesophageal cancers; a false-negative or unsatisfactory result was given in four patients. A false-positive diagnosis of cancer was not made. There were 13 true-negative reports. These findings result in a sensitivity of 83% with 95% CI of 74.82-91.18%; a specificity of 100% (CI of 98.5-100%) a positive predictive value of 100% (CI of 99.25-100%); a negative predictive value of 48% (CI of 29.16-64.84%); (iv) of 81 patients with proven cancer, in 79 (98%) at least one of the methods was positive. In only two patients with cancer were both methods negative. These finding result in a combined sensitivity of 98% (CI of 94.92-100%); a specificity of 100% (CI of 98.5-100%); a positive predictive value of 100% (CI of 99.31-100%); and a negative predictive value of 87% CI of 70-100%). Our series confirms the value of the combined use of cytology and biopsy for the investigation of oesophageal lesions.
