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Warman M, Kamar Matias A, Yosepovich A, Halperin D, Cohen O. Inflammatory Profile of Antrochoanal Polyps in the Caucasian Population - A Histologic Study. Am J Rhinol Allergy 2021; 35:664-673. [PMID: 33544623 DOI: 10.1177/1945892421990529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Antrochoanal polyp (ACP) is a rare and unique unilateral nasal polyp. In contrast to diffuse primary chronic rhinosinusitis (d-CRS) the inflammatory profile of ACP in the Caucasian population have not been determined. OBJECTIVE The purpose of the study is to describe and differentiate the inflammatory features of ACP compared with d-CRS and its phenotypic subgroups and hypertrophic turbinates (HT) in the Caucasian population, and compare the mast and plasma cell marker expression of each pathology. METHODS A retrospective case control study of 96 patients operated on between the years 2005-2017. Nasal biopsies of ACPs, d-CRS and HTs were compared. A comparison of the different phenotypic subgroups of d-CRS was made as well. Demographics, comorbidities, and histologic and immunohistochemical (IHC) staining of mast (CD117) and plasma cell (CD138) receptor antibodies, were compared and analyzed. RESULTS A total of 96 patients were included, consisting of 40 (41.6%) ACP, 36 (37.5%) d-CRS and 20 (20.8%) HT patients. ACPs displayed a significantly higher level of edema and intramural cysts compared to the other groups. Squamous metaplasia was demonstrated in ACP (27.5%) and d-CRS (25.6%), but not in HT. The ACP group was characterized by neutrophilic predominant infiltrates as opposed to the eosinophilic predominance in the d-CRS group, especially in eosinophilic CRS and central compartment allergic disease. ACP presented lower levels of both mast and plasma cells compared to d-CRS and HT in IHC staining. CONCLUSIONS ACP in the Caucasian population has unique features of cyst formation and edema which is compatible with its clinical presentation. It is characterized by neutrophilic predominant infiltrates and expresses lower levels of mast and plasma cells as demonstrated by IHC.
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Affiliation(s)
- Meir Warman
- Department of Otorhinolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hebrew University, Hadassah Medical School, Jerusalem, Israel
| | | | - Ady Yosepovich
- Hebrew University, Hadassah Medical School, Jerusalem, Israel.,Department of Pathology, Kaplan Medical Center, Rehovot, Israel
| | - Doron Halperin
- Department of Otorhinolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hebrew University, Hadassah Medical School, Jerusalem, Israel
| | - Oded Cohen
- Department of Otorhinolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hebrew University, Hadassah Medical School, Jerusalem, Israel
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Jairajpuri ZS, Rana S, Hajela A, Jetley S. Toward early diagnosis of oral cancer: Diagnostic utility of cytomorphological features, a pilot study. Natl J Maxillofac Surg 2019; 10:20-26. [PMID: 31205384 PMCID: PMC6563646 DOI: 10.4103/njms.njms_12_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction: Early detection of oral cancer is one of the most efficient ways to reduce the high mortality from this disease because of the ready accessibility of the oral cavity. We need to devise urgent diagnostic tools to detect early oral premalignant and malignant lesions. Aim: The aim of the present study was to grade the oral lesions in an attempt toward developing a novel cytological grading system. Further, morphometric analysis of cellular parameters was also performed to compare their significance in differentiating benign from malignant lesions. Materials and Methods: The present study was conducted at a tertiary care hospital catering to the low socioeconomic population. Patients presenting in the various Out Patient Departments with suspicious oral lesions were evaluated by cytology in the Department of Pathology. Results: A total of 72 patients were evaluated with a mean age of 43.54 ± 10.35 years. The involvement of the buccal mucosa was the most common site of oral lesions. Cytologically, the lesions were graded according to the oral/oro-pharyngeal cytology grading system into grades A to F. Cyto-morphometric analysis showed an increasing trend in mean nuclear diameter from benign to malignant cases while the mean cytoplasmic diameter decreased, value of P < 0.05 was observed indicating a statistically significant difference between the two groups. Conclusions: Cytological features of pleomorphism are a unique feature in oral carcinoma reflecting intracellular alterations in cells. Grading of lesions according to cytological characteristics can be helpful in standardizing the reporting of the oral lesion. However, our study was restricted by limited data; we emphasize more extensive studies to assess the usefulness and applicability of such a grading system. We also conclude that the use of cytomorphometry can improve the diagnostic reliability of exfoliative cytology.
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Affiliation(s)
- Zeeba Shamim Jairajpuri
- Departments of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Safia Rana
- Departments of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Apoorva Hajela
- Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Sujata Jetley
- Departments of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
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Ye X, Zhang J, Tan Y, Chen G, Zhou G. Meta-analysis of two computer-assisted screening methods for diagnosing oral precancer and cancer. Oral Oncol 2015; 51:966-975. [PMID: 26384539 DOI: 10.1016/j.oraloncology.2015.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 09/03/2015] [Accepted: 09/04/2015] [Indexed: 11/27/2022]
Abstract
The early diagnosis of oral precancer and cancer is crucial and could have the highest impact on improving survival rates. A meta-analysis was conducted to compare the accuracy between the OralCDx brush biopsy and DNA-image cytometry in diagnosing both conditions. Bibliographic databases were systematically searched for original relevant studies on the early diagnosis of oral precancer and oral cancer. Study characteristics were evaluated to determine the accuracy of the two screening strategies. Thirteen studies (eight of OralCDx brush biopsy and five of DNA-image cytometry) were identified as having reported on 1981 oral mucosa lesions. The meta-analysis found that the area under the summary receiver operating characteristic curves of the OralCDx brush biopsy and DNA-image cytometry were 0.8879 and 0.9885, respectively. The pooled sensitivity, specificity, and diagnostic odds ratio of the OralCDx brush biopsy were 86% (95% CI 81-90), 81% (95% CI 78-85), and 20.36 (95% CI 2.72-152.67), respectively, while these modalities of DNA-image cytometry were 89% (95% CI 83-94), 99% (95% CI 97-100), and 446.08 (95% CI 73.36-2712.43), respectively. Results of a pairwise comparison between each modality demonstrated that specificity, area under the curve (AUC), and Q(∗) index of DNA-image cytometry was significantly higher than that of the OralCDx brush biopsy (Z=2.821, p<0.05; Z=1.711, p<0.05; Z=1.727, p<0.05), but no significant difference in sensitivity was found (Z=1.520, p>0.05). In conclusion, the meta-analysis of the published studies indicated that DNA-image cytometry is more accurate than the OralCDx brush biopsy in diagnosing oral precancer and oral cancer.
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Affiliation(s)
- Xiaojing Ye
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Jing Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China; Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Yaqin Tan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Guanying Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Gang Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China; Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China.
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Richards AL, Sugumaran M, Aviv JE, Woo P, Altman KW. The utility of office-based biopsy for laryngopharyngeal lesions: Comparison with surgical evaluation. Laryngoscope 2014; 125:909-12. [DOI: 10.1002/lary.25005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/14/2014] [Accepted: 10/07/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Amanda L. Richards
- Department of Otolaryngology-Head and Neck Surgery; Icahn School of Medicine, Mount Sinai Hospital; New York New York U.S.A
| | - Manikandan Sugumaran
- Department of Otolaryngology-Head and Neck Surgery; Icahn School of Medicine, Mount Sinai Hospital; New York New York U.S.A
| | - Jonathan E. Aviv
- Department of Otolaryngology-Head and Neck Surgery; Icahn School of Medicine, Mount Sinai Hospital; New York New York U.S.A
| | - Peak Woo
- Department of Otolaryngology-Head and Neck Surgery; Icahn School of Medicine, Mount Sinai Hospital; New York New York U.S.A
| | - Kenneth W. Altman
- Department of Otolaryngology-Head and Neck Surgery; Icahn School of Medicine, Mount Sinai Hospital; New York New York U.S.A
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SOUSA MICHELECARDOSO, ALVES MONICAGHISLAINEOLIVEIRA, SOUZA LUCIANOALBINO, BRANDÃO ADRIANAAIGOTTIHABERBECK, ALMEIDA JANETEDIAS, CABRAL LUIZANTONIOGUIMARÃES. Correlation of clinical, cytological and histological findings in oral squamous cell carcinomas. Oncol Lett 2014; 8:799-802. [PMID: 25013502 PMCID: PMC4081384 DOI: 10.3892/ol.2014.2212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 04/24/2014] [Indexed: 11/23/2022] Open
Abstract
The present study aimed to investigate the efficiency of exfoliative cytology by correlating the clinical lesions of oral squamous cell carcinoma (OSCC) with exfoliative cytology and histopathological findings. Cases of OSCC diagnosed between 1984 and 2010 were analyzed. The inclusion criteria for the present study were the availability of detailed clinical findings and a diagnosis of the disease through exfoliative cytology and histopathology. The cases were assessed and assigned scores, which were then submitted to modal expression analysis, which considers the higher frequency scores, thus relating the variables. The cytological findings demonstrated that the majority of the cases had malignant potential. Exfoliative cytology should be used as a supplementary tool for the diagnosis of OSCC, as it enables the early detection of these lesions. However, cytology should not be used as a substitute for histopathological examination.
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Affiliation(s)
- MICHELE CARDOSO SOUSA
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
| | - MONICA GHISLAINE OLIVEIRA ALVES
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
| | - LUCIANO ALBINO SOUZA
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
| | - ADRIANA AIGOTTI HABERBECK BRANDÃO
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
| | - JANETE DIAS ALMEIDA
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
| | - LUIZ ANTONIO GUIMARÃES CABRAL
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP, Univ. Estadual Paulista, São José dos Campos, São Paulo 12245-000, Brazil
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Afrogheh A, Wright CA, Sellars SL, Wetter J, Pelser A, Schubert PT, Hille J. An evaluation of the Shandon Papspin liquid-based oral test using a novel cytologic scoring system. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 113:799-807. [PMID: 22668708 DOI: 10.1016/j.oooo.2012.01.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 01/25/2012] [Accepted: 01/26/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate a cost-effective oral liquid-based cytology screening test, Shandon Papspin (PS). STUDY DESIGN We compared the diagnostic accuracy of PS with surgical biopsy in 69 patients. Transepithelial cytology specimens were obtained with the use of cervical cytobrushes. Cytology specimens were graded and scored by using a novel oral cytologic grading and scoring system. RESULTS Histologic diagnosis of dysplasia or malignancy was made in 51/69 cases, and cytology identified 49/51 cases, with a sensitivity of 96% and specificity of 100%. The best cutoff value for distinguishing reactive/mildly dysplastic lesions from high grade/invasive squamous cell carcinoma was determined to be a cytologic score of 3, representing a sensitivity of 95% and specificity of 96%. CONCLUSIONS PS appears to be an accurate and economical test for detection of high-risk dysplasias and cancers, but the real significance of this method will be its diagnostic accuracy in studies focusing strictly on lesions with a low level of clinical concern.
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Affiliation(s)
- Amir Afrogheh
- Department of Oral Pathology, University of the Western Cape and National Health Laboratory Services, Tygerberg Hospital, Cape Town, South Africa.
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Babshet M, Nandimath K, Pervatikar S, Naikmasur V. Efficacy of oral brush cytology in the evaluation of the oral premalignant and malignant lesions. J Cytol 2011; 28:165-72. [PMID: 22090689 PMCID: PMC3214460 DOI: 10.4103/0970-9371.86342] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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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Affiliation(s)
- M Babshet
- Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
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Pérez-Sayáns M, Somoza-Martín JM, Barros-Angueira F, Reboiras-López MD, Gándara-Vila P, Gándara Rey JM, García-García A. Exfoliative cytology for diagnosing oral cancer. Biotech Histochem 2010; 85:177-87. [PMID: 20426699 DOI: 10.3109/10520290903162730] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Exfoliative cytology is a minimally invasive technique for obtaining oral cell specimens from patients for diagnostic purposes. Classical applications of oral cytology studies, such as oral candidiasis, have been extended to include oral precancerous and cancerous lesions. A number of analytical methods are available for studying cytology specimens. The development of molecular analysis techniques, the oral cancer etiopathogenic process, and improvements in liquid-based exfoliative cytology are leading to renewed interest in exfoliative cytology. Results sometimes are disputed, so the aim of our review was to clarify the applicability of exfoliative cytology to the diagnosis of oral precancerous and cancerous lesions.
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Affiliation(s)
- M Pérez-Sayáns
- School of Dentistry, Entrerríos s/n, Santiago of Compostela C.P. 15782, Spain.
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9
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DeCoro M, Wilder-Smith P. Potential of optical coherence tomography for early diagnosis of oral malignancies. Expert Rev Anticancer Ther 2010; 10:321-9. [PMID: 20214513 DOI: 10.1586/era.09.191] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
With nearly 1,500,000 new patients diagnosed every year in the USA, cancer poses a considerable challenge to healthcare today. Oral cancer is responsible for a sizeable portion of deaths due to cancer, primarily because it is diagnosed at a late stage when the prognosis is poor. Current methods for diagnosing oral cancer need to be augmented by better early detection, monitoring and screening modalities. A new approach is needed that provides real-time, accurate, noninvasive diagnosis. The results of early clinical trials using in vivo optical coherence tomography for the diagnosis of oral dysplasia and malignancy are encouraging.
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Affiliation(s)
- Michael DeCoro
- Beckman Laser Institute, 1002 Health Sciences Road East, University of California, Irvine, CA 92612, USA.
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Wilder-Smith P, Lee K, Guo S, Zhang J, Osann K, Chen Z, Messadi D. In vivo diagnosis of oral dysplasia and malignancy using optical coherence tomography: preliminary studies in 50 patients. Lasers Surg Med 2009; 41:353-7. [PMID: 19533765 DOI: 10.1002/lsm.20773] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND In vivo, non-invasive optical coherence tomography (OCT) permits high-resolution imaging of tissue surfaces and subsurfaces, with the potential capability for detection and mapping of epithelial pathologies. PURPOSE To evaluate the clinical capability of non-invasive in vivo OCT for diagnosing oral dysplasia and malignancy. EXPERIMENTAL DESIGN In 50 patients with oral lesions, conventional clinical examination was followed by OCT imaging, then standard biopsy and histopathology. Two blinded, pre-standardized investigators separately diagnosed each lesion based on (1) OCT and (2) histopathology. RESULTS Intra- and inter-observer agreement between diagnoses based on histopathology and imaging data was excellent, with lambda values between 0.844 and 0.896. Sensitivity and specificity were also very good. CONCLUSIONS These data demonstrate the excellent capability of in vivo OCT for detecting and diagnosing oral premalignancy and malignancy in human subjects.
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Affiliation(s)
- Petra Wilder-Smith
- Beckman Laser Institute, University of California, Irvine, California 92612, USA.
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Moralis A, Kunkel M, Reichert TE, Kosmehl H, Driemel O. [Identification of a recurrent oral squamous cell carcinoma by brush cytology]. MUND-, KIEFER- UND GESICHTSCHIRURGIE : MKG 2007; 11:355-8. [PMID: 17929066 DOI: 10.1007/s10006-007-0080-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Large oral lesions comprise the risk that an incisional biopsy does not reveal the most aggressive site in spite of carefully selecting the place of biopsy. CASE REPORT The first incisional biopsy of a large, clinically suspect, oral lesion could not identify the subepidermal spread of a recurrent oral squamous cell carcinoma. Atypical cells obtained by a simultaneous brush biopsy prompted a renewed, incisional biopsy which finally established the diagnosis of a recurrent, oral squamous cell carcinoma. CONCLUSIONS The presented case emphasizes the value of brush biopsy in the follow-up of oral squamous cell carcinoma, especially in examination of oral lesions covering a large area.
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Affiliation(s)
- Antonios Moralis
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Universität Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
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Hullmann M, Reichert TE, Dahse R, von Eggeling F, Pistner H, Kosmehl H, Driemel O. [Oral cytology: historical development, current status, and perspectives]. MUND-, KIEFER- UND GESICHTSCHIRURGIE : MKG 2007; 11:1-9. [PMID: 17177045 DOI: 10.1007/s10006-006-0041-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Oral cytology has aroused new interest caused by introduction of the cytobrush as a sampling device and the use of additional analytical methods. By brushing it is possible to reach deeper layers of the oral mucosa where squamous intraepithelial neoplasia (SIN) begins. The biological potential of the oral epithelial cells obtained can be evaluated by the following additional methods: computer-assisted image analysis (OralCDx), DNA cytometry, immunohistochemistry, monolayer cytology, and molecular biological analysis. All of those methods can increase sensitivity (up to 100%) and specificity (up to 100%) of oral brush biopsy. Nevertheless, there are reports that oral epithelial carcinomas were not identified. No comparative study exists allowing conclusions to be drawn about the value of the single methods. Immunocytochemistry with commercial antibodies against laminin-5 is generally available and methodologically easy. Oral brush biopsy as a non invasive diagnostic method can be useful for the early detection of oral mucosal lesions. Positive findings or progression of the lesion despite negative findings are indications to refer the patient to a specialized clinic where a surgical biopsy should be performed, followed by histopathological analysis. Histopathology remains the gold standard for the definitive diagnosis of oral malignant lesions.
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Affiliation(s)
- M Hullmann
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Klinikum der Universität Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
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Mehrotra R, Gupta A, Singh M, Ibrahim R. Application of cytology and molecular biology in diagnosing premalignant or malignant oral lesions. Mol Cancer 2006; 5:11. [PMID: 16556320 PMCID: PMC1448188 DOI: 10.1186/1476-4598-5-11] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2005] [Accepted: 03/23/2006] [Indexed: 11/29/2022] Open
Abstract
Early detection of a premalignant or cancerous oral lesion promises to improve the survival and the morbidity of patients suffering from these conditions. Cytological study of oral cells is a non-aggressive technique that is well accepted by the patient, and is therefore an attractive option for the early diagnosis of oral cancer, including epithelial atypia and squamous cell carcinoma. However its usage has been limited so far due to poor sensitivity and specificity in diagnosing oral malignancies. Lately it has re-emerged due to improved methods and it's application in oral precancer and cancer as a diagnostic and predictive method as well as for monitoring patients. Newer diagnostic techniques such as "brush biopsy" and molecular studies have been developed. Recent advances in cytological techniques and novel aspects of applications of scraped or exfoliative cytology for detecting these lesions and predicting their progression or recurrence are reviewed here.
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Affiliation(s)
- Ravi Mehrotra
- Associate Professor Department of Pathology, Moti Lal Nehru Medical College, Allahabad, India
| | - Anurag Gupta
- Postgraduate Student Department of Pathology, Moti Lal Nehru Medical College, Allahabad, India
| | - Mamta Singh
- Professor and Head Department of Pathology, Moti Lal Nehru Medical College, Allahabad, India
| | - Rahela Ibrahim
- Research Fellow Department of Pathology, Moti Lal Nehru Medical College, Allahabad, India
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Farouk R, Dodds J, MacDonald AW, Young W, Duthie GS, Lee PW, Monson JR. Feasibility study for use of brush cytology as a complementary method for diagnosis of rectal cancer. Dis Colon Rectum 1997; 40:609-13. [PMID: 9152193 DOI: 10.1007/bf02055388] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
UNLABELLED Brush cytology has previously been described as a feasible method for accurately diagnosing colorectal cancer. PURPOSE This study was designed: 1) to determine the sensitivity and specificity of brush cytology for the diagnosis of rectal cancer; 2) to prospectively assess the extent of interobserver variability with this technique; 3) to prospectively examine the cost impact of the addition of brush cytology as a routine method of confirming the diagnosis of rectal cancer. PATIENTS AND METHODS Three hundred fifty-seven patients who attended a rectal clinica and who were found to have a lesion between January 1990 and March 1996 were assessed. Each patient underwent rigid proctoscopy, followed by brush cytology and tissue biopsy. Results were compared with the final histologic diagnosis in each patient. The brushings from the last 92 consecutive patients in this series were independently examined by four cytologists and a pathologist to determine the rate of interobserver variability. RESULTS Rectal adenocarcinoma was confirmed from surgically resected specimens in 303 patients. Brush cytology accurately diagnosed 278 of them. Of the remaining 25 patients, two had brushings that were insufficient for diagnosis. There was one false-positive case. Forceps biopsy correctly identified cancer in 260 patients, with no false-positive interpretations. Brush cytology accurately identified 53 of 54 adenomas as being benign, and forceps biopsy correctly identified all as benign. Sensitivity of brush cytology in this series was 92 percent, with a specificity of 92 percent. Interobserver agreement was 84 percent. Actual costs incurred with this method was an additional $17.00 per patient. CONCLUSIONS Brush cytology can accurately diagnose rectal cancer in a high proportion of patients. Interobserver variation is low and compares favorably with other forms of cytologic interpretation. The additional cost remains a concern but can be kept within acceptable proportion.
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Affiliation(s)
- R Farouk
- Academic Surgical Unit, University of Hull, United Kingdom
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Clayman L. MANAGEMENT OF MUCOSAL PREMALIGNANT LESIONS. Oral Maxillofac Surg Clin North Am 1994. [DOI: 10.1016/s1042-3699(20)30764-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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