Utility of Glove Touch Imprint Cytology Obtained During Digital Rectal Examination: A Novel Point-of-Care Screening Tool for Anorectal Malignancy

A BSTRACT Background and Objectives: Digital rectal examination (DRE) is an essential step in the evaluation of anorectal malignancies; however, the gold standard is histopathological diagnosis. In this study, we evaluated the feasibility of detecting malignant cells from glove-touch imprints obtained during DRE in patients with clinically suspected or biopsy-proven anorectal malignancies. Patients and Methods: A total of 50 patients with suspicious or biopsy-proven anorectal malignancy who visited the outpatient services of the tertiary care center in INDIA, between July 2023 and December 2024, underwent DRE. Touch-imprint cytology (TIC) analysis of the gloved finger was performed for the detection of malignant cells and compared with the histological examination of tissue obtained via proctoscopy/sigmoidoscopy. Results: Comparison of TIC with histopathological biopsy showed statistically significant results ( P < 0.001) in detecting anorectal malignancy. The technique demonstrated a sensitivity of 89.4%, specificity of 100%, positive predictive value of 100%, negative predictive value of 28.6%, and an overall diagnostic accuracy of 89.8%. Several demographic, clinical, and procedural variables were also assessed for their influence on cytological yield. Among these, symptom duration, distance of the lesion from the anal verge, T stage of disease, and the number of imprint slides containing abnormal cells emerged as statistically significant factors affecting diagnostic outcomes. Conclusion: The study suggested “glove TIC” as a rapid, simple, cost-effective, minimally invasive, and highly specific tool for screening anorectal malignancy.