The diagnostic accuracy of papanicolau staining in brush biopsy as an alternative to tissue biopsy in patients undergoing colonoscopy for non-obstructing colonic tumors at Vicente Sotto Memorial Medical Center from February 2016 to September 2017: A prospective study

Abstract

Background:
In the Philippines in 2010, colorectal cancer combined ranked 4th for both sexes. Early detection of colorectal malignancy remains in the forefront of long-term management.

Objective:
The study was conducted to determine the diagnostic accuracy of papanicolau stain in detecting malignancy from brush biopsy specimens in patients undergoing colonoscopy.

Methodology:
A prospective, open label 19-month study from February 2016 to September 2017 was done on patients aged 19 years and above. On colonoscopy, brush biopsies around the four sides of tumors were sampled after the tissue biopsy procedure, smeared to slides, fixed in 95% ethyl alcohol, stained using papanicolau method and read by two independent pathologists.

Research Instrument:
Tabulated data sheets and statistical analysis using SPSS.

Results:
There were 60 subjects who underwent colonoscopy for colonic tumors, with average age of 55.60 years, 53.3% of whom were females. 50% were smokers, and 85% had history of colon cancer in the family. There was a significant association of papanicolau stain in detecting malignancy (p=0.002), with sensitivity of 79.2% and specificity of 66.6%.

Conclusion:
Papanicolau stain shows good sensitivity, correctly identifying 79.2% of patients who truly have colon cancer, with fair specificity at 66.6%.