Efficacy of Oral Brush Cytology in the Evaluation of the Oral Premalignant and Malignant Lesions

Overview

Journal J Cytol

Specialty Cell Biology

Date 2011 Nov 18

PMID 22090689

Citations 30

Authors

M Babshet

K Nandimath

Sk Pervatikar

Vg Naikmasur

Affiliations

Soon will be listed here.

Abstract

Objective: In the present study, oral brush cytology of premalignant and malignant lesions was performed using tooth brush. The cytopathological diagnosis of brush cytology was compared with that of punch biopsy. The reliability of oral brush cytology using tooth brush was assessed in terms of sensitivity and specificity.

Materials And Methods: A total of 67 patients, 32 premalignant lesions and other 35 frank oral carcinomas, were included in the study. All patients underwent oral brush cytology using a toothbrush followed by punch biopsy. Sensitivity, specificity, positive and negative predictive values were calculated. Cytopathology and histopathology of premalignant and malignant lesions were compared using Mann-Whitney U test. Inter- and intra-examiner reliability was calculated using Rank-correlation coefficient.

Results: Two in premalignant group and five in malignant group were marked insufficient. 18% of cases were false negatives. The sensitivity, specificity, positive predictive value and negative predictive value were 77%, 100%, 100% and 38%, respectively. Statistical analysis showed P>0.05, suggesting that there is no significant difference between histopathology and brush cytology in assessing both premalignant and malignant lesions. Inter- and intra-examiner reliability were 99.22% and 99.77%, respectively.

Conclusion: Brush cytology using a tooth brush is reliable and can be easily performed with less cost and discomfort to the patient. It is useful in those situations when a patient refuses to have a biopsy performed or when medically compromised patients would be exposed to unnecessary surgical risks. It can be used for screening for suspicious oral lesions, and may have applications in resource-challenged areas.

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References

Scheifele C, Schmidt-Westhausen A, Dietrich T, Reichart P . The sensitivity and specificity of the OralCDx technique: evaluation of 103 cases. Oral Oncol. 2004; 40(8):824-8. DOI: 10.1016/j.oraloncology.2004.02.004. View

Jones A, Pink F, Sandow P, Stewart C, Migliorati C, Baughman R . The Cytobrush Plus cell collector in oral cytology. Oral Surg Oral Med Oral Pathol. 1994; 77(1):95-9. View

Nichols M, QUINN Jr F, Schnadig V, Zaharopoulos P, Hokanson J, Des Jardins L . Interobserver variability in the interpretation of brush cytologic studies from head and neck lesions. Arch Otolaryngol Head Neck Surg. 1991; 117(12):1350-5. DOI: 10.1001/archotol.1991.01870240042006. View

Sciubba J . Improving detection of precancerous and cancerous oral lesions. Computer-assisted analysis of the oral brush biopsy. U.S. Collaborative OralCDx Study Group. J Am Dent Assoc. 1999; 130(10):1445-57. DOI: 10.14219/jada.archive.1999.0055. View

Mehrotra R, Singh M, Kumar D, Pandey A, Gupta R, Sinha U . Age specific incidence rate and pathological spectrum of oral cancer in Allahabad. Indian J Med Sci. 2003; 57(9):400-4. View

Wingo P, Tong T, Bolden S . Cancer statistics, 1995. CA Cancer J Clin. 1995; 45(1):8-30. DOI: 10.3322/canjclin.45.1.8. View

Gupta P, Nandakumar A . Oral cancer scene in India. Oral Dis. 1999; 5(1):1-2. DOI: 10.1111/j.1601-0825.1999.tb00055.x. View

Scheifele C, Reichart P . Is there a natural limit of the transformation rate of oral leukoplakia?. Oral Oncol. 2003; 39(5):470-5. DOI: 10.1016/s1368-8375(03)00006-x. View

Mehrotra R, Singh M, Pandya S, Singh M . The use of an oral brush biopsy without computer-assisted analysis in the evaluation of oral lesions: a study of 94 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106(2):246-53. DOI: 10.1016/j.tripleo.2008.02.030. View

10.

Remmerbach T, Weidenbach H, Pomjanski N, Knops K, Mathes S, Hemprich A . Cytologic and DNA-cytometric early diagnosis of oral cancer. Anal Cell Pathol. 2001; 22(4):211-21. PMC: 4617997. DOI: 10.1155/2001/807358. View

11.

Poate T, Buchanan J, Hodgson T, Speight P, Barrett A, Moles D . An audit of the efficacy of the oral brush biopsy technique in a specialist Oral Medicine unit. Oral Oncol. 2004; 40(8):829-34. DOI: 10.1016/j.oraloncology.2004.02.005. View

12.

Driemel O, Kunkel M, Hullmann M, Kleinsasser N, Staudenmaier R, Muller-Richter U . [Performance of conventional oral brush biopsies]. HNO. 2008; 56(2):205-10. DOI: 10.1007/s00106-007-1662-1. View

13.

Nasiell K, NASIELL M, Vaclavinkova V . Behavior of moderate cervical dysplasia during long-term follow-up. Obstet Gynecol. 1983; 61(5):609-14. View

14.

Vooijs G, Elias A, Van der Graaf Y . The influence of sample takers on the cellular composition of cervical smears. Acta Cytol. 1986; 30(3):251-7. View

15.

Chute D, Stelow E . Cytology of head and neck squamous cell carcinoma variants. Diagn Cytopathol. 2009; 38(1):65-80. DOI: 10.1002/dc.21134. View

16.

Bhat S, Hegde K, George R . Microbial contamination of tooth brushes and their decontamination. J Indian Soc Pedod Prev Dent. 2004; 21(3):108-12. View

17.

Felefli S, Flaitz C . The oral brush biopsy: it's as easy as 1, 2, 3. Tex Dent J. 2002; 117(6):20-4. View

18.

Potter T, Summerlin D, Campbell J . Oral malignancies associated with negative transepithelial brush biopsy. J Oral Maxillofac Surg. 2003; 61(6):674-7. DOI: 10.1053/joms.2003.50136. View