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Santamarina-García M, Brea-Iglesias J, Bramsen JB, Fuentes-Losada M, Caneiro-Gómez FJ, Vázquez-Bueno JÁ, Lázare-Iglesias H, Fernández-Díaz N, Sánchez-Rivadulla L, Betancor YZ, Ferreiro-Pantín M, Conesa-Zamora P, Antúnez-López JR, Kawazu M, Esteller M, Andersen CL, Tubio JMC, López-López R, Ruiz-Bañobre J. MSIMEP: Predicting microsatellite instability from microarray DNA methylation tumor profiles. iScience 2023; 26:106127. [PMID: 36879816 PMCID: PMC9984554 DOI: 10.1016/j.isci.2023.106127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 12/15/2022] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Deficiency in DNA MMR activity results in tumors with a hypermutator phenotype, termed microsatellite instability (MSI). Beyond its utility in Lynch syndrome screening algorithms, today MSI has gained importance as predictive biomarker for various anti-PD-1 therapies across many different tumor types. Over the past years, many computational methods have emerged to infer MSI using either DNA- or RNA-based approaches. Considering this together with the fact that MSI-high tumors frequently exhibit a hypermethylated phenotype, herein we developed and validated MSIMEP, a computational tool for predicting MSI status from microarray DNA methylation tumor profiles of colorectal cancer samples. We demonstrated that MSIMEP optimized and reduced models have high performance in predicting MSI in different colorectal cancer cohorts. Moreover, we tested its consistency in other tumor types with high prevalence of MSI such as gastric and endometrial cancers. Finally, we demonstrated better performance of both MSIMEP models vis-à-vis a MLH1 promoter methylation-based one in colorectal cancer.
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Affiliation(s)
- Martín Santamarina-García
- Genomes and Disease, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
| | - Jenifer Brea-Iglesias
- Genomes and Disease, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.,Translational Oncology Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Álvaro Cunqueiro Hospital, 36213 Vigo, Spain
| | | | - Mar Fuentes-Losada
- Department of Medical Oncology, University Clinical Hospital of Santiago de Compostela (SERGAS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.,Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
| | - Francisco Javier Caneiro-Gómez
- Department of Pathology, University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
| | | | - Héctor Lázare-Iglesias
- Department of Pathology, University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
| | - Natalia Fernández-Díaz
- Department of Medical Oncology, University Clinical Hospital of Santiago de Compostela (SERGAS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.,Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
| | - Laura Sánchez-Rivadulla
- Department of Gynaecology and Obstetrics, Complejo Hospitalario Universitario de Ferrol, 15405 Ferrol, Spain
| | - Yoel Z Betancor
- Genomes and Disease, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.,Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
| | - Miriam Ferreiro-Pantín
- Genomes and Disease, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.,Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
| | - Pablo Conesa-Zamora
- Department of Clinical Analysis, Santa Lucía University Hospital, 30202 Cartagena, Spain
| | - José Ramón Antúnez-López
- Department of Pathology, University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
| | - Masahito Kawazu
- Chiba Cancer Center, Research Institute, 260-0801 Chiba, Japan.,Division of Cellular Signaling, National Cancer Center Research Institute, 104-0045 Tokyo, Japan
| | - Manel Esteller
- Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Barcelona, Spain.,Institucio Catalana de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain.,Physiological Sciences Department, School of Medicine and Health Sciences, University of Barcelona (UB), 08907 Barcelona, Spain.,Centro de Investigación Biomédica en Red Cáncer (CIBERONC), 28029 Madrid, Spain
| | | | - Jose M C Tubio
- Genomes and Disease, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain
| | - Rafael López-López
- Department of Medical Oncology, University Clinical Hospital of Santiago de Compostela (SERGAS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.,Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red Cáncer (CIBERONC), 28029 Madrid, Spain
| | - Juan Ruiz-Bañobre
- Genomes and Disease, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.,Department of Medical Oncology, University Clinical Hospital of Santiago de Compostela (SERGAS), University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.,Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red Cáncer (CIBERONC), 28029 Madrid, Spain
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2
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Seoane-Viaño I, Gómez-Lado N, Lázare-Iglesias H, García-Otero X, Antúnez-López JR, Ruibal Á, Varela-Correa JJ, Aguiar P, Basit AW, Otero-Espinar FJ, González-Barcia M, Goyanes A, Luzardo-Álvarez A, Fernández-Ferreiro A. 3D Printed Tacrolimus Rectal Formulations Ameliorate Colitis in an Experimental Animal Model of Inflammatory Bowel Disease. Biomedicines 2020; 8:E563. [PMID: 33276641 PMCID: PMC7761558 DOI: 10.3390/biomedicines8120563] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to fabricate novel self-supporting tacrolimus suppositories using semisolid extrusion 3-dimensional printing (3DP) and to investigate their efficacy in an experimental model of inflammatory bowel disease. Blends of Gelucire 44/14 and coconut oil were employed as lipid excipients to obtain suppository formulations with self-emulsifying properties, which were then tested in a TNBS (2,4,6-trinitrobenzenesulfonic acid) induced rat colitis model. Disease activity was monitored using PET/CT medical imaging; maximum standardized uptake values (SUVmax), a measure of tissue radiotracer accumulation rate, together with body weight changes and histological assessments, were used as inflammatory indices to monitor treatment efficacy. Following tacrolimus treatment, a significant reduction in SUVmax was observed on days 7 and 10 in the rat colon sections compared to non-treated animals. Histological analysis using Nancy index confirmed disease remission. Moreover, statistical analysis showed a positive correlation (R2 = 71.48%) between SUVmax values and weight changes over time. Overall, this study demonstrates the effectiveness of 3D printed tacrolimus suppositories to ameliorate colitis and highlights the utility of non-invasive PET/CT imaging to evaluate new therapies in the preclinical area.
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Affiliation(s)
- Iria Seoane-Viaño
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Noemí Gómez-Lado
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
| | - Héctor Lázare-Iglesias
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain; (H.L.-I.); (J.R.A.-L.)
| | - Xurxo García-Otero
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
| | - José Ramón Antúnez-López
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain; (H.L.-I.); (J.R.A.-L.)
| | - Álvaro Ruibal
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
- Tejerina Foundation, José Abascal 40, 28003 Madrid, Spain
| | - Juan Jesús Varela-Correa
- Pharmacy Department, University Hospital Ourense (SERGAS), Calle Ramón Puga Noguerol 54, 32005 Ourense, Spain;
| | - Pablo Aguiar
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (N.G.-L.); (Á.R.); (P.A.)
| | - Abdul W. Basit
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK;
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Francisco J. Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain;
| | - Alvaro Goyanes
- FabRx Ltd., 3 Romney Road, Ashford, Kent TN24 0RW, UK;
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma Group (GI-1645), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Asteria Luzardo-Álvarez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain; (I.S.-V.); (X.G.-O.); (F.J.O.-E.)
- Paraquasil Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), 15706 Santiago de Compostela, Spain;
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
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3
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Seoane-Viaño I, Gómez-Lado N, Lázare-Iglesias H, Rey-Bretal D, Lamela-Gómez I, Otero-Espinar FJ, Blanco-Méndez J, Antúnez-López JR, Pombo-Pasín M, Aguiar P, Ruibal Á, Luzardo-Álvarez A, Fernández-Ferreiro A. Evaluation of the therapeutic activity of melatonin and resveratrol in Inflammatory Bowel Disease: A longitudinal PET/CT study in an animal model. Int J Pharm 2019; 572:118713. [PMID: 31593809 DOI: 10.1016/j.ijpharm.2019.118713] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 12/29/2022]
Abstract
Inflammatory Bowel Disease (IBD) is a group of chronic disorders of the gastrointestinal tract, which two main types are Crohn's disease and ulcerative colitis. Although conventional therapeutic strategies have demonstrated to be effective in the IBD treatment, it is necessary to incorporate novel therapeutic agents that target other mechanisms involved in the pathogenesis of the disease, such as oxidative stress. For this reason, the efficacy in vivo of two antioxidant compounds, melatonin and resveratrol, has been investigated in an animal model of TNBS (2, 4, 6-trinitrobenzenesulfonic acid) induced colitis. PET/CT (Positron emission tomography/Computer Tomography) scans were performed to assess disease activity and evaluate treatment response. SUVmax (Standardized Uptake Value) values, body weight changes and histological evaluation were used as inflammatory indices to measure the efficacy of both treatments. SUVmax values increased rapidly after induction of colitis, but after the beginning of the treatment (day 3) a statistically significant decrease was observed on days 7 and 10 in treated animals compared to the non-treated group. This remission of the disease was also confirmed by histological analysis of the colon tissue using the Nancy histological index (p value < 0.05 for differences between non-treated and both groups of treated animals). Moreover, statistical analysis showed a correlation (R2 = 65.52%) between SUVmax values and weight changes throughout the treatment. Overall, this study demonstrates the potential of resveratrol, and melatonin in lower extent, as therapeutic agents in the IBD treatment.
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Affiliation(s)
- Iria Seoane-Viaño
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - Noemí Gómez-Lado
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - Héctor Lázare-Iglesias
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - David Rey-Bretal
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - Iván Lamela-Gómez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - José Blanco-Méndez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain
| | - José Ramón Antúnez-López
- Pathology Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - María Pombo-Pasín
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain
| | - Pablo Aguiar
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain; Molecular Imaging Group, Department of Psiquiatry, Radiology and Public Health, Faculty of Medicine, Universidade de Santiago de Compostela (USC), Santiago de Compostela Zip Code: 15782, Spain
| | - Álvaro Ruibal
- Nuclear Medicine Department and Molecular Imaging Group, University Clinical Hospital (CHUS) and Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain; Molecular Imaging Group, Department of Psiquiatry, Radiology and Public Health, Faculty of Medicine, Universidade de Santiago de Compostela (USC), Santiago de Compostela Zip Code: 15782, Spain; Tejerina Foundation, José Abascal 40, Madrid Zip Code: 28003, Spain
| | - Asteria Luzardo-Álvarez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain.
| | - Anxo Fernández-Ferreiro
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), Campus Vida, Santiago de Compostela Zip Code: 15782, Spain; Pharmacy Department, University Clinical Hospital Santiago de Compostela (SERGAS) (CHUS), Travesía da Choupana s/n, Santiago de Compostela Zip Code: 15706, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Travesía da Choupana s/n, Santiago de Compostela, Zip Code: 15706, Spain.
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Pérez-Sayáns M, Reboiras-López MD, Gayoso-Diz P, Seijas-Naya F, Antúnez-López JR, Gándara-Rey JM, García-García A. Non-computer-assisted liquid-based cytology for diagnosis of oral squamous cell carcinoma. Biotech Histochem 2011; 87:59-65. [PMID: 21526909 DOI: 10.3109/10520295.2011.575797] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The development of oral squamous cell carcinoma (OSCC) occasionally follows the neoplastic progression of other premalignant lesions. Although biopsy is the definitive diagnostic method, liquid-based cytology is an adequate method for screening suspicious lesions. We compared liquid-based cytology to histology for diagnosis of OSCC in patients with oral lesions that raised clinical suspicion of malignancy. Our sample consisted of 48 patients. Cytological samples were obtained by scraping the lesion superficially using Cytobrush®. We conducted cytological and histopathological evaluation of all preparations. We estimated sensitivity and specificity levels as well as positive and negative predictive values. The degree of inter-observer agreement for both methods was assessed using the kappa index. Twenty-eight (58.3%) of the cases finally were diagnosed with OSCC and 20 (41.7%) were determined to be premalignant lesions. We observed eight false negatives and no false positives; OSCC prevalence was 56.5%. The values for diagnostic indices were: sensitivity, 69% (CI 95%, prevalence 51.87); specificity, 100%; positive predictive value, 100%; negative predictive value, 71% (CI 95% 54.82). A kappa index of 0.622 (CI 95% 0.93, 0.39) was observed.
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Affiliation(s)
- M Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Entrerrios s/n Santiago de Compostela C.P. 15782, Spain.
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Reboiras-López MD, Pérez-Sayáns M, Somoza-Martín JM, Antúnez-López JR, Gándara-Vila P, Gayoso-Diz P, Gándara-Rey JM, García-García A. Comparison of three sampling instruments, Cytobrush, Curette and OralCDx, for liquid-based cytology of the oral mucosa. Biotech Histochem 2011; 87:51-8. [PMID: 21341980 DOI: 10.3109/10520295.2011.560895] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Exfoliative cytology of the oral cavity is a simple and noninvasive technique that permits the study of epithelial cells. Liquid-based cytology is an auxiliary diagnostic tool for improving the specificity and sensitivity of conventional cytology. The objective of our study was to compare the quality of normal oral mucosa cytology samples obtained using three different instruments, Cytobrush®, dermatological curette and Oral CDx® for liquid-based cytology. One hundred four cytological samples of oral cavity were analyzed. Samples were obtained from healthy volunteer subjects using all three instruments. The clinical and demographic variables were age, sex and smoking habits. We analyzed cellularity, quality of the preparation and types of cells in the samples. All preparations showed appropriate preparation quality. In all smears analyzed, cells were distributed uniformly and showed no mucus, bleeding, inflammatory exudate or artifacts. We found no correlation between the average number of cells and the type of instrument. The samples generally consisted of two types of cells: superficial and intermediate. No differences were found among the cytological preparations of these three instruments. We did not observe basal cells in any of the samples analyzed.
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Affiliation(s)
- M D Reboiras-López
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Entrerríos s/n, Santiago de Compostela, Spain.
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