IADR Abstract Archives
Diagnostic Accuracy of Liquid Based Brush Cytology in Oral Oncology
Objectives: This study aimed to determine the criteria for diagnosis of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) using oral liquid-based brush cytology (OLBC); and to determine the accuracy of OLBC compared to the gold standard of surgical biopsy and histopathology.
Methods: Preliminary data from 39 patients clinically diagnosed with OSCC and OPMD were analysed. A pilot study was initially undertaken to set the diagnostic cytopathological criteria. All patients with oral mucosal lesions underwent Orcellex® brush biopsy followed by surgical biopsy. Cytological samples were processed using ThinPrep® system according to the manufacturer instructions (Hologic, Australia). Slides were stained by Papanicolaou method and assessed for specimen adequacy, preparation quality, types of observed cells and cytological abnormalities using the criteria that were defined by the pilot study. Cyto-histopathological correlation was then undertaken.
Results: The pilot study included 11 samples used as a training set comprising 4 normal oral mucosa, 5 oral epithelial dysplasia (OED) and 2 OSCC. The remaining 28 cases used as a test set were grouped histopathologically into 3 benign squamous papilloma, 11 hyperkeratosis without dysplasia, 4 oral lichen planus and 10 OED. Inadequate samples were seen in 25% (7/28) of the test set due to lack of satisfactory cellularity. Representative cell populations were observed in all liquid-based preparations. The cytology diagnoses matched the histopathology evaluation in 83% of cases. In OED lesions, a cyto-histopathological mismatch was found in only 2 cases. The majority of patients (75%) reported no or minimal discomfort with brush biopsy technique when local anaesthetic was not administered.
Conclusions: Oral brush liquid based cytology using Orcellex® brush and ThinPrep® system is a simple procedure for adequate mucosal sampling which can be performed with minimal discomfort to patients. The present preliminary data support moderate agreement between cytological and histopathological diagnoses. Further evaluation is still required and ongoing.
Methods: Preliminary data from 39 patients clinically diagnosed with OSCC and OPMD were analysed. A pilot study was initially undertaken to set the diagnostic cytopathological criteria. All patients with oral mucosal lesions underwent Orcellex® brush biopsy followed by surgical biopsy. Cytological samples were processed using ThinPrep® system according to the manufacturer instructions (Hologic, Australia). Slides were stained by Papanicolaou method and assessed for specimen adequacy, preparation quality, types of observed cells and cytological abnormalities using the criteria that were defined by the pilot study. Cyto-histopathological correlation was then undertaken.
Results: The pilot study included 11 samples used as a training set comprising 4 normal oral mucosa, 5 oral epithelial dysplasia (OED) and 2 OSCC. The remaining 28 cases used as a test set were grouped histopathologically into 3 benign squamous papilloma, 11 hyperkeratosis without dysplasia, 4 oral lichen planus and 10 OED. Inadequate samples were seen in 25% (7/28) of the test set due to lack of satisfactory cellularity. Representative cell populations were observed in all liquid-based preparations. The cytology diagnoses matched the histopathology evaluation in 83% of cases. In OED lesions, a cyto-histopathological mismatch was found in only 2 cases. The majority of patients (75%) reported no or minimal discomfort with brush biopsy technique when local anaesthetic was not administered.
Conclusions: Oral brush liquid based cytology using Orcellex® brush and ThinPrep® system is a simple procedure for adequate mucosal sampling which can be performed with minimal discomfort to patients. The present preliminary data support moderate agreement between cytological and histopathological diagnoses. Further evaluation is still required and ongoing.