ORIGINAL ARTICLE A prospective comparison of brush cytology before and after biopsy in diagnosis of gastric malignancies Mohammad Reza Fattahi 1 & Bita Geramizadeh 2 & Kourosh Masriadi 2 & Masood Sepehrimanesh 1 & Ali Reza Safarpour 1 Received: 16 February 2016 /Accepted: 19 July 2016 /Published online: 26 July 2016 # Springer-Verlag London 2016 Abstract Gastric malignancies are the third most common causes of cancer-related death in the world. Here, we aimed to compare brush cytology before and after biopsy in the di- agnosis of gastric malignancies. This prospective study in- cluded 74 cases referred to endoscopy clinic for suspected gastric lesions during 1 year. In 38 cases, brush cytology was done before and in 36 cases it was done after biopsy. All the cytology and biopsy slides were randomly coded and reviewed by a pathologist blindly without any knowledge of the surgical pathology result or clinical data of the patients. Diagnostic accuracy of brush cytology before biopsy was sig- nificantly higher than after biopsy (86.8 vs. 52.8 %, P = 0.003). This accuracy did not show any relations to the site of the lesion or endoscopic appearance of it (P > 0.05). We suggest endoscopic biopsy and cytology to be done together, especially in highly suspected cases to malignancy and also our study showed that it is better to do brushing before tissue biopsy. Keywords Brush cytology . Diagnostic accuracy . Malignancy . Biopsy Introduction Gastric cancer is one of the most common malignancies of the gastrointestinal (GI) tract (Ajani et al. 2013). There are several methods for the diagnosis of these cancers (Evans et al. 2013; Kobayashi and Kasugai 1977). Endoscopic biopsy and brushing cytology are widely used concomitantly in the diag- nosis of these tumors (Salto-Tellez et al. 2016). Although, there are several reports regarding the value of combined cy- tology and biopsy in the diagnosis of gastric cancers (Geramizadeh et al. 2002; Padmavathy et al. 2011; Qizilbash et al. 1979), and also some reports in comparison of these two techniques in other diseases and conditions (Goodson et al. 2013; Karmarkar et al. 2013), but still there are few reports about the comparison of doing brushing before or after biopsy (Keighley et al. 1979; Zargar et al. 1990). The aim of the present study was to compare the diagnostic accuracy of brushing obtained before and after biopsy in pa- tients suspected to gastric cancer in the upper GI endoscopy. Patients and methods Ethical statement The protocol of the study was approved by the Ethical Committee of Shiraz University of Medical Sciences, Shiraz, Iran. The written forms of agreement for participation in this study were obtained from all patients. Procedure In this interventional study, 74 cases were selected due to the presence of any gastric lesions suspicious to malignancy. In 38 cases, brushing was done before and in 36 cases it was done Mohammad Reza Fatahi and Masood Sepehrimanesh have the same contribution to this study. * Mohammad Reza Fattahi fattahim38@yahoo.com Masood Sepehrimanesh sepehrimaneshmasood@gmail.com 1 Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, PO Box: 71345-1414, Shiraz, Iran 2 Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran Comp Clin Pathol (2016) 25:1043–1045 DOI 10.1007/s00580-016-2306-1