<b>Gastric cytology: a supplement to early diagnosis of gastric malignancies</b>

<b>Introduction</b>: Gastric cancer is the fifth most common malignancy worldwide with high morbidity and mortality. Endoscopic gastric cytology and biopsy aid in early diagnosis and management. This study evaluates the diagnostic yield of gastric cytology in diagnosing gastric lesions with histopathology as the gold standard.<b>Methods</b>: This retrospective, cross-sectional study was conducted in the Department of Pathology for a period of 3.5 years. The cases with clinical suspicion of gastric malignancy and those who have had both cytology and histopathology examination were included. Cytology results were reported as positive for malignancy, suspicious for malignancy, atypical cells- favor reactive and negative for malignancy. The cytology and histopathology results were correlated, and descriptive statistics were used to analyze data.<b>Results</b>: Among 118 patients included in the study, 103 cases were malignant and 15 were nonmalignant. Out of 103 malignant cases, 89 cases were detected in cytology. False positive cases consisted of 4 gastritis with florid reactive atypia and one with moderate dysplasia. False negative cases were seen more often in diffuse and intestinal subtype of adenocarcinoma, followed by non-Hodgkin lymphoma. Sensitivity and specificity were found to be 86.41% and 66.67% respectively. Positive predictive value of 94.68% with 41.67% negative predictive value and diagnostic accuracy of 83.90%.<b>Conclusion</b>: Gastric cytology is a reliable screening and diagnostic tool with a high positive predictive value and acceptable sensitivity. Negative cytology in endoscopically suspected cases of gastric malignancy should always be correlated with biopsy reports. Gastric malignancy is known to be present as diffuse thickening of gastric wall, like diffuse subtype of adenocarcinoma and non-Hodgkin lymphoma is a pitfall on cytology because of low cellularity. Gastric cytology is a cost effective and rapidly performed technique with high positive predictive value, sensitivity and diagnostic accuracy.