431 OBJECTIVE: To evaluate the specificity and sensitivity of brush cytology and biopsy in colorectal malignancies. STUDY DESIGN: The study was performed over 3 years, 1998–2000. Seventy- six patients with any colorec- tal lesion on colonoscopy were selected, and in all of them brush cytology and biopsy were done at the same time. The cytologic smears and biopsies were reviewed separately. The cytologic smears were categorized as negative, suspicious, sugges- tive or positive for malignancy. The results of cytology and biopsy were compared based on sensitivity and spec- ificity. The gold standard for positive cases was the tissue specimen after surgery; negative cases were followed for at least 1 year. Cases with 1 year of disease-free survival were considered negative. RESULTS: Among 76 cases, 4 were excluded because of unsatisfactory cytologic smears. Of the remaining 72 cases, 31 were male and 41 female. The age range was 19–80 years. Cytology showed 23 positive and 49 nega- tive cases (1 false positive and 3 false negative). Biopsy showed 24 positive and 48 negative cases (no false posi- tives and 1 false negative). There were 47 negative cases, followed for at least 1 year, and after that we considered them definitively negative for malignancy. Sensitivity of cytology and biopsy was 88% and 96%; specificity was 98% and 100%, respec- tively. Combined use of brush cytology and biopsy had the highest sensitivity, 100%. CONCLUSION: Brush cytology of the colon is a safe, fast and reliable method for the diagnosis of colorectal cancer. We recommend performing it in conjunction with biopsy. It is also reasonable to perform a repeat biop- sy in patients with negative biopsy and positive cytology for a definitive diagnosis. (Acta Cytol 2003;47: 431–434) Keywords: colorectal cancer, colonoscopy, brush cytology. Colorectal carcinoma is one of the most common malignancies of the gastrointestinal tract. The most important prognostic factor in it is the extent of the From the Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran. Dr. Geramizadeh is Assistant Professor. Dr. Hooshmand is Senior Resident. Dr. Kumar is Professor. Address reprint requests to: Bita Geramizadeh, M.D., Pathology Department, Shiraz University of Medical Sciences, P.O. Box 1864, Shi- raz, Iran 71344. Financial Disclosure: The authors have no connection to any companies or products mentioned in this article. Received for publication April 29, 2002. Accepted for publication July 23, 2002. Brush Cytology of Colorectal Malignancies Bita Geramizadeh, M.D., Farhang Hooshmand, M.D., and Perikala V. Kumar, M.D., M.I.A.C. Acta Cytologica 0001-5547/03/4703-0431/$19.00/0 © The International Academy of Cytology Acta Cytologica Brush cytology of the colon is a safe, fast and reliable method for the diagnosis of colorectal cancer. DO NOT DUPLICATE © Copyrighted Material