Modern endoscopic instruments for examination of the esophagus and stomach are constructed to allow diagnostic cytology by brushing and biopsy of lesions under direct vision. The conditions of all 26 patients with cancer of the upper gastrointestinal tract were correctly diagnosed by the combination of direct-vision brushing cytology and biopsy, while roentgenographic and endoscopic examination alone were successful in only 73.3% and 83.3% of the cases, respectively. Such instruments, therefore, provide a safe, convenient, and accurate method for the definitive, microscopical diagnosis of gastroesophageal malignancy. They are of special value in the correct identification of malignant gastric ulcers of benign gross appearance.
Kobayashi S, Prolla JC, Winans CS, Kirsner JB. Improved Endoscopic Diagnosis of Gastroesophageal MalignancyCombined Use of Direct Vision Brushing Cytology and Biopsy. JAMA. 1970;212(12):2086–2089. doi:10.1001/jama.1970.03170250042006