The Utility Of Imprint Cytology Of Gastrointestinal Endoscopic Tissue Biopsies At Kenyatta National Hospital

Abstract

ackground: Endoscopic histology is the gold standard for diagnosis of gastrointestinal pathology. Touch imprint cytology of endoscopic biopsies is rapid, inexpensive method for diagnosis of gastrointestinal pathology. Whereas there are less than eight published studies that examine the utility of imprint cytology of endoscopic biopsies as a tool for rapid diagnosis of gastrointestinal infections and malignancies, none are from Africa. This study examined the utility of imprint cytology of endoscopic biopsies for rapid diagnosis of inflammatory, pre-malignant and malignant gastrointestinal pathology. Objectives: The main objective was to establish the utility of imprint cytology in the diagnosis of GIT lesions at Kenyatta National Hospital. Materials and Method: This study was a cross sectional descriptive study and was carried out on 124 patients in Endoscopy Unit, Kenyatta National Hospital, within a period of 3 months. Endoscopic biopsies were gently rolled on two microscopic slides to make imprint smears- prior to formalin fixation. Both slides were air dried and subsequently stained with Papanicolaou and Giemsa stains. Cytological features were described and displayed using photomicrographs. Diagnostic performance of imprint cytology was calculated and expressed in percentage. Results: A total number of 124 participants were included in this study and Imprint cytology revealed that 37 (29.83%) were positive for malignancy whereas 34 (27.41%) were positive H.pylori. The overall accuracy of imprint cytology for malignancy and for H.pylori was excellent (94% and 90% respectively). Conclusions: Imprint cytology is an easy and rapid procedure for detection of infectious, benign and malignant diseases of gastrointestinal tract. Imprint cytology has a high accuracy, sensitivity and specificity in diagnosis of GIT malignancy and for H .pylori infection. Recommendations: Imprint cytology can be routinely performed alongside endoscopic biopsy for diagnosis of bacteriologic and helminthic infections in the digestive tract. Imprint cytology should be used to enable early planning for further management of the patient and to help to avoid a repeat of procedure in case of inadequate biopsy.