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IDDF2019-ABS-0319 The diagnostic accuracy of papanicolau staining in brush biopsy as an alternative to tissue biopsy in patients undergoing colonoscopy for non-obstructing colonic tumors

Background The study was conducted to determine the diagnostic accuracy of papanicolau stain in detecting malignancy from brush biopsy specimens in patients undergoing colonoscopy. Methods A prospective, open-label 19-month study, covering February 2016- September 2017 of patients aged 19 years and above. Demographics and informed consent of all patients undergoing colonoscopy were taken. On colonoscopy, brush biopsies around the four sides of tumors were sampled after the tissue biopsy then smeared to slides, fixed with 95% ethyl alcohol and stained with Papanicolau method and read by 2 independent pathologists. Results 60 patients underwent colonoscopy for colonic tumors. The average age was 55.60 years old, 53.3% were females, 85% had a family history of colon cancer and 50% were smokers. A significant association of Pap stain in detecting malignancy (p=0.002) was noted with a sensitivity of 79.2% and specificity of 66.6%. Conclusions The results show good sensitivity of using Pap stain in that it is able to correctly identify 79.2% for patients who truly have colonic tumors with specificity of 66.6%. There is a significant association between Pap stain and H&E stain in detecting malignancy (p=0.002) in that a positive Pap stain is highly associated with colon cancer detection (PPV=90.5%) and only 44.4% will be truly negative for those who have no colon cancer.