Low positive predictive value of the oral brush biopsy in detecting dysplastic oral lesions.
BACKGROUND
The authors evaluated the effectiveness of the oral brush biopsy technique as a diagnostic tool in detecting dysplastic oral lesions.


METHODS
In this cross-sectional study, pathologic reports (n = 152) from the scalpel biopsies (tissue samples) in patients who previously tested either "positive" (n = 3) or "atypical" (n = 149) for dysplasia by brush biopsy (OralCDx) were evaluated. Information on the age and sex of the patient, the site of the lesion, the brush biopsy results, and the histopathologic diagnosis of the scalpel biopsy was collected. The positive predictive values (PPVs) for "abnormal," "atypical," and "positive" brush biopsies were determined.


RESULTS
Overall, the PPV of an abnormal brush biopsy was only 7.9% (95% confidence interval [CI], 4.2%-13.4%), and the PPV of an "atypical" brush biopsy was 7.4% (95% CI, 3.7%-12.8%). Of the 3 positive brush biopsies, only 1 was identified as dysplastic. The proportion of false-positive biopsy results was as high as 92.1% (95% CI, 86.6%-95.9%).


CONCLUSIONS
The OralCDx technique overestimated dysplastic lesions and produced a high number of false-positive results.
Bhoopathi
Vinodh
V
Division of Dental Public Health, Boston University School of Dental Medicine, Boston, Massachusetts 02117, USA.
Kabani
Sadru
S
Mascarenhas
Ana Karina
AK
D001706:Biopsy / Q000379:methods*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008871:Microvilli / Q000473:pathology; D008875:Middle Aged; D009059:Mouth Diseases / Q000175:diagnosis / Q000473:pathology*; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000473:pathology*; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology