Brush cytology and biops under direct vision was performed on 250 patients. Of the 44 proven cases with cancers of the upper gastrointestinal tract, brush cytology yielded positive results in 88.6%, and multiple mucosal biopsies yielded positive results in 93.2%. With the combined technique the results increased to 95.4%. False-negative results were due to large tumors with necrotic surfaces or to infiltrative tumors at the cardioesophageal junction. There was 1 false positive with brush cytology and 0 with biopsy. Four cases of early gastric cancer were diagnosed with the combined technique.